Primary and radiation induced skull base osteosarcoma: a systematic review of clinical features and treatment outcomes

Othman Bin Alamer, Ali S. Haider, Maryam Haider, Navraj S. Sagoo, Faith C. Robertson, Eliel N. Arrey, Salah G. Aoun, Kenny Yu, Aaron A. Cohen-Gadol, Tarek Y. El Ahmadieh

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Purpose: We aim to systematically review and summarize the demographics, clinical features, management strategies, and clinical outcomes of primary and radiation-induced skull-base osteosarcoma (SBO). Methods: PubMed, Scopus, and Cochrane databases were used to identify relevant articles. Papers including SBO cases and sufficient clinical outcome data were included. A comprehensive clinical characteristic review and survival analysis were also conducted. Results: Forty-one studies describing 67 patients were included. The median age was 31 years (male = 59.7%). The middle skull-base was most commonly involved (52.7%), followed by anterior (34.5%) and posterior (12.7%) skull-base. Headache (27%), exophthalmos (18%), and diplopia (10%) were common presenting symptoms. Sixty-eight percent of patients had primary SBO, while 25% had radiation-induced SBO. Surgery was the main treatment modality in 89% of cases. Chemotherapy was administered in 65.7% and radiotherapy in 50%. Median progression-free survival (PFS) was 12 months, and the overall 5-year survival was 22%. The five-year survival rates of radiation-induced SBO and primary SBO were 39% and 16%, respectively (P < 0.05). Conclusion: SBO is a malignant disease with poor survival outcomes. Surgical resection is the primary management modality, in conjunction with chemotherapy and radiotherapy. Radiation-induced SBO has a superior survival outcome as compared to its primary counterpart. Complete surgical resection showed a statistically insignificant survival benefit as compared to partial resection.

Original languageEnglish (US)
Pages (from-to)183-202
Number of pages20
JournalJournal of Neuro-Oncology
Issue number2
StatePublished - Jun 2021


  • Primary osteosarcoma
  • Radiation induced osteosarcoma
  • Skull-base osteosarcoma
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research


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