Clinical Benefits of Proton Beam Therapy for Tumors of the Skull Base

Kamran A. Ahmed, MD; Stephanie K. Demetriou; Mark McDonald, MD; Peter A.S. Johnstone, MD


Cancer Control. 2016;23(3):213-219. 

In This Article

Abstract and Introduction


Background: The unique radiobiological properties of protons have been understood for many years. In addition, many of the clinical benefits of radiotherapy were first noted in tumors involving the skull base. More public attention has been given to proton beam therapy due to the increasing number of centers now in operation or in the planning stages for offering this treatment option.

Methods: We reviewed the physical properties of protons and the clinical studies performed to justify their use in the management of skull-base tumors and determine the benefits of proton beam therapy.

Results: Published reports suggest a benefit to proton beam therapy for use in tumors of the skull base, including craniopharyngiomas, chordomas, skull-base sarcomas, and unresectable meningiomas.

Conclusions: Use of proton beam therapy may be beneficial in select patients. Surgical and medical oncologists should have a general understanding of such cases to facilitate their appropriate referral.


Proton beam therapy has risen in popularity in recent years as a treatment modality in the field of radiation oncology. More than 10 centers are in operation with many more proton centers under construction or in the planning stages.[1] There are proven benefits to proton treatment in select patients, including those with chordomas, skull-base tumors, and in the setting of childhood malignancies where doses initiated in proximity to adjacent normal structures are of critical importance.[2–5] The potential therapeutic benefit of proton beam therapy is being investigated in many other disease sites, including tumors of the lung, pancreas, esophagus, prostate, and cervix.[6–10]

In this review, we summarize the unique properties of protons that make them particularly beneficial for the treatment of skull-base lesions and review the results of clinical studies supporting their use.