Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: the Greek experience.
OBJECTIVE
To estimate the value of LINAC-based stereotactic radiosurgery (SRS) for the long-term local control of unilateral acoustic neuromas.


METHODS
Twenty patients (median age 66; range 57-80 years) with unilateral acoustic neuroma underwent LINAC-based SRS from May 2000 through June 2004 with a dose of 11-12 Gy. The follow-up period ranged from 36 to 84 months (median follow-up period: 55 months). Before SRS none of the patients had useful hearing. The follow-up consisted of repeat imaging studies and clinical examination for assessment of facial and trigeminal nerve function at 6-month intervals for the first year and yearly thereafter.


RESULTS
Eleven tumors (58%) decreased in size and eight (42%) remained stable. One tumor showed a minor increase in size on the MRI done 6 months after SRS in comparison with the pretreatment MRI; however, a subsequent decrease was noticed on the next radiographic assessment and the tumor remained stable from then on. None of the tumors increased in size in the long-term follow-up, thus giving an overall growth control of 100% for the patients in this study. None of the patients had useful hearing before SRS, so hearing level was not assessed during follow-up. No patient developed new, permanent facial or trigeminal neuropathy.


CONCLUSIONS
LINAC-based SRS with 11-12 Gy provides excellent tumor control in acoustic neuroma and has low toxicity even after long-term follow-up.
Kalogeridi
Maria-Aggeliki
MA
Radiotherapy Unit, Medical School, National University of Athens, Greece. ma_kalogeridi@yahoo.com
Georgolopoulou
Paraskevi
P
Kouloulias
Vassilis
V
Kouvaris
John
J
Pissakas
George
G
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D016634:Radiosurgery / Q000009:adverse effects; D016896:Treatment Outcome