Table 1.

Patients, their diagnoses and treatment plans

Patient	Diagnoses	Age	Treatment	Type of fractionation	Chemo	Follow-up (mo)	Response
1	Low-grade astrocytoma	16Y	28 × 1.8 Gy	IMRS with MLC	Yes	12	Resolution
2	Juvenile Pilocytic Astrocytoma	12Y	1 × 20 Gy	Conical Collimators	Yes	6	Resolution
3	Pituitary Macroadenoma	15Y	28 × 1.8 Gy	IMRS with MLC	Yes	12	Required another resection
4	Acoustic Schwannoma	16Y	28 × 1.8 Gy	IMRS with MLC	No	3	Stable
5	Medulloblastoma Metastasis	12Y	14 × 1 Gy	Conical Collimators	Yes	12	Stable
6	Pituitary Prolactinoma	18Y	28 × 1.8 Gy	IMRS with MLC	Yes	18	Stable
7	Pineocytoma	19Y	5 × 5 Gy	IMRS with MLC	No	12	Local control with subsequent metastasis
8	Juvenile Pilocytic Astrocytoma	14Y	1 × 20 Gy	Conical Collimators	No	10	Stable
9	Pituitary Macroadenoma	12Y	28 × 1.8 Gy	IMRS with MLC	Yes	15	Decreased GH level

Patient number 3: a 15-year-old female with a growth-hormone-secreting pituitary macroadenoma, underwent subtotal resection in December of 2005. Post-operatively had residual tumor in the right cavernous sinus that encased the cavernous portion of the carotid artery as well as the proximal right middle cerebral artery and anterior communicating artery. On serial MRI, she was noted to have subsequent tumor growth and marked mass effect on the optic chiasm. In August of 2006, she underwent fractionated radiotherapy to a dose of 50.4 Gy in 28 fractions of 1.8 Gy. She tolerated the procedure well but on follow-up MRI, there was growth of her residual tumor, and she underwent a second resection in November of 2006

Patient number 4: a 16-year-old male with a history of type II neurofibromatosis with bilateral acoustic and trigeminal nerve neuromas. He received a course of fractionated IMRT to his left acoustic neuroma, which measured 2.5 cm in maximal diameter. He received a dose of 50.4 Gy in 28 fractions of 1.8 Gy. Post-therapy, he was able to maintain hearing bilaterally without any new neurological deficits. There was no change in the size of his neuroma but there was some hypointensity in the central portion of the lesion suggestive of radiation therapy effect

Patient number 6: an 18-year-old male with a history of recurrent pituitary prolactinoma following multiple resections, most recently on December of 2005. Residual disease was noted involving the left cavernous sinus and associated left internal carotid artery. The patient continued to have elevated levels of prolactin despite aggressive endocrinologic intervention and his MRI was concerning for recurrence. He received a course of external beam stereotactic radiotherapy to his pituitary region to a dose of 50.4 Gy, completed in April 2006. He tolerated the procedure and his existing bitemporal hemianopsia remains stable. He had no other neurological deficits. Follow-up MRI in November of 2006 indicated no increase in size of the pituitary mass with mild interval decrease in enhancement of the solid component, likely related to necrosis

Patient number 8: a 14-year-old male, post-two-surgical resections for a posterior fossa JPA with 1 cm residual adjacent to the site of the tumor resection. He underwent SRS to a dose of 20 Gy. The patient tolerated the procedure well. At 10 months post-treatment, a follow-up MRI demonstrated regression of the lesion

Patient number 9: a 12-year-old male with a pituitary adenoma and acromegaly who underwent a resection in October of 2005. The patient had a residual intracavernous lesion measuring 1.4 cm × 1.0 cm and received a dose of 50.4 Gy in May of 2006 with no complications. He has been continued on methimazole and somatostatin with reduction in his growth hormone levels. He suffered no focal neurological deficits and tolerated the procedure well