[Fractionated irradiation of cerebellopontine angle neurinoma: 12 years' experience of the Bordeaux University Hospital Center].
OBJECTIVE
To evaluate retrospectively the long-term results of fractionated radiation therapy (RT) in cerebello-pontine angle neurinomas (CPA).


METHODS
From January 1986 to October 1995, 29 patients with stage III and IV neurinomas were treated with external fractionated RT. One patient was irradiated on both sides and indications for RT were as follows: (1) general contraindications for surgery (16 patients); (2) hearing preservation in bilateral neurinomas after controlateral tumor exeresis (six patients); (3) partial tumor removal (five patients); and, (4) non-surgical recurrence (three patients). A three to four fields technique with coplanar static beams and conformal cerobend blocks was used; doses were calculated on a 95 to 98% isodoses and were given five days a week for a median total dose of 51 Gy (1.8 Gy/fraction). Most patients were irradiated with 6 to 10 MV photons).


RESULTS
Median follow-up was 66 months (seven to 120 months). Seven patients died, two with progressive disease, five from non-tumoral causes. Tumor shrinkage was observed in 13 patients (43.3%), stable disease in 14 (46.6%), and tumor progression in three. Two patients underwent total tumor removal after RT (one stable and one growing tumor). Hearing was preserved in four out of six patients. No patient experienced facial or trigeminal neuropathy.


CONCLUSIONS
Fractionated RT is a well tolerated and efficacious treatment of large non-surgical CPA neurinomas.
Maire
J P
JP
Service de radiothérapie, hôpital Saint-André, Bordeaux, France.
Trouette
R
R
Darrouzet
V
V
San Galli
F
F
Causse
N
N
Huchet
A
A
Vendrely
V
V
Guérin
J
J
Caudry
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002528:Cerebellar Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D002530:Cerebellopontine Angle; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D009442:Neurilemmoma / Q000453:epidemiology / Q000532:radiotherapy* / Q000601:surgery; D011882:Radiotherapy, High-Energy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome