title: Cyberknife radiosurgery for trigeminal schwannomas.
abstract: OBJECTIVE
  Trigeminal schwannomas (TS) are benign tumors that are managed by surgical resection and/or stereotactic radiosurgery. Most radiosurgical series report results using the gamma knife. The CyberKnife (Accuray, Inc., Sunnyvale, CA) is a frameless, robotic stereotactic radiosurgical system. In this series, we report our experience using the CyberKnife in the treatment of TS.
  
  
  METHODS
  We retrospectively reviewed the medical records and diagnostic imaging in 13 consecutive patients with TS who were treated with the CyberKnife from 2003 to 2007. Seven patients had a previous surgical resection. The mean tumor volume was 6.3 mL (range, 0.39-19.98 mL), and the mean marginal dose was 18.5 Gy. Six of the tumors were treated in a single session. The mean clinical follow-up period was 21.8 months (range, 7-53 months).
  
  
  RESULTS
  In this series, the tumor control rate was 100%. The average reduction in tumor volume was 45% (range, 14-98%). A modest improvement in facial pain was noted in 4 of the 6 patients who presented with this symptom. One patient had improvement in facial numbness, and another had improvement in pretreatment headaches. One patient developed jaw weakness and facial dysesthesia, and another patient developed asymptomatic radiation necrosis.
  
  
  CONCLUSIONS
  Although the length of follow-up is limited, we report our initial experience with CyberKnife treatment of TS. Our results demonstrate tumor control rates and clinical outcomes that parallel those of previous reports using gamma knife radiosurgery; however, long-term follow-up studies are needed.
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305, USA. gsaka@stanford.edu
authors.forename: Gordon T
authors.initials: GT
authors.lastname: Sakamoto
authors.forename: D John
authors.initials: DJ
authors.lastname: Borchers
authors.forename: Furen
authors.initials: F
authors.lastname: Xiao
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Yang
authors.forename: Steven D
authors.initials: SD
authors.lastname: Chang
authors.forename: John R
authors.initials: JR
authors.lastname: Adler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000473:pathology / Q000601:surgery*