This review article provides a summary and evaluation on the current evidence of PT in the treatment of gliomas, meningioma, craniopharyngioma, pituitary adenoma, vestibular schwannoma, chordoma and chondrosarcoma of the base of the skull, secondary malignancies and reirradiation. This review also provides recommendations for when and how to use of PT in the discussed settings. The authors pointed out that there is a need to generate high-level evidence through prospective trials and data collection and until this is available, consider therapeutic individualized decision making.