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.