Fractionated radiation therapy in the treatment of stage III and IV cerebello-pontine angle neurinomas: long-term results in 24 cases.
OBJECTIVE
To reevaluate long-term results of fractionated radiation therapy (RT) in a previously published series of cerebello-pontine angle neurinomas (CPA).


METHODS
From January 1986 to May 1992, 24 patients with Stage III and IV CPA neurinomas were treated with external fractionated RT; 7 patients had phacomatosis. One patient was irradiated on both sides and indications for radiotherapy were as follows: (a) poor general condition or old age contraindicating surgery, 14 cases; (b) hearing preservation in bilateral neurinomas after contralateral tumor removal, 5 cases; (c) partial resection or high risk of recurrence after subsequent surgery for relapse, 4 cases; (d) nonsurgical relapse, 2 cases. Most patients were irradiated with 9 MV photons. A three- to four-field technique with coned-down portals was used. Doses were calculated on a 95% isodose and were given 5 days a week for a mean total dose of 51 Gy (1.80 Gy/fraction).


RESULTS
Median follow-up from RT was 60 months (7 to 84); five patients died, two with progressive disease. Two patients underwent total tumor removal after RT (one stable and one growing tumor). On the whole, tumor shrinkage was observed in 9 patients (36%), stable disease in 13 (52%), and tumor progression in 3. Hearing was maintained in 3 out of 5 hearing patients with phacomatosis.


CONCLUSIONS
Fractionated RT appears to be an effective and well-tolerated treatment for Stage III and IV CPA neurinomas. Hearing can be preserved for a long time.
Maire
J P
JP
Service de Radiothérapie, Hôpital Saint-André, Bordeaux, France.
Caudry
M
M
Darrouzet
V
V
Guérin
J
J
Trouette
R
R
Bébéar
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D002530:Cerebellopontine Angle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed