Long-term outcome of stereotactic radiosurgery (SRS) in patients with acoustic neuromas.
OBJECTIVE
To evaluate the effectiveness and long-term outcome of stereotactic radiosurgery (SRS) for acoustic neuromas (AN).


METHODS
Between 1990 and 2001, we treated 26 patients with 27 AN with SRS. Two patients suffered from neurofibromatosis type 2. Before SRS, a subtotal or total resection had been performed in 3 and in 5 patients, respectively. For SRS, a median single dose of 13 Gy/80% isodose was applied.


RESULTS
The overall actuarial 5-year and 10-year tumor control probability in all patients was 91%. Two patients developed tumor progression after SRS at 36 and 48 months. Nineteen patients (73%) were at risk of treatment-related facial nerve toxicity; of these, 1 patient developed a complete facial nerve palsy after SRS (5%). A total of 93% of the lesions treated were at risk of radiation-induced trigeminal neuralgia. Two patients (8%) developed mild dysesthesia of the trigeminal nerve after SRS. The hearing preservation rate in patients with useful hearing before SRS was 55% at 9 years.


CONCLUSIONS
Stereotactic radiosurgery results in good local control rates of AN and the risk of cranial nerve toxicities is acceptable. As toxicity is lower with fractionated stereotactic radiotherapy, SRS should be reserved for smaller lesions.
Combs
Stephanie E
SE
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. Stephanie.Combs@med.uni-heidelberg.de
Thilmann
Christoph
C
Debus
Jürgen
J
Schulz-Ertner
Daniela
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005154:Facial Nerve / Q000528:radiation effects; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006309:Hearing / Q000502:physiology / Q000528:radiation effects*; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016518:Neurofibromatosis 2 / Q000150:complications; D009464:Neuroma, Acoustic / Q000601:surgery*; D011832:Radiation Injuries / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects; D014277:Trigeminal Neuralgia / Q000209:etiology