title: Comparison of stereotactic radiosurgery and fractionated stereotactic radiotherapy of acoustic neurinomas according to 3-D tumor volume shrinkage and quality of life.
abstract: OBJECTIVE
  Stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT.
  
  
  METHODS
  From 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up > or = 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36.
  
  
  RESULTS
  Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and 87.5%/87.2% (SRT). TV shrinkage was 15.1%/40.7% (SRS/SRT; p = 0.01). Single dose (< 13 Gy) was the only determinant factor for TV shrinkage after SRS (p = 0.001). Age, gender, initial TV, and previous operations did not affect TV shrinkage. Acute or late toxicity (> or = grade 3) was never seen. Concerning QoL, no significant differences were observed after SRS/SRT. Previous operations and gender did not affect QoL (p > 0.05). Compared with the German normal population, patients had worse values for all domains except for mental health.
  
  
  CONCLUSIONS
  TV shrinkage was significantly higher after SRT than after SRS. Main symptoms were not affected by SRS/SRT. Retrospectively, QoL was neither affected by SRS nor by SRT.
authors.affiliation: Department of Radiation Oncology, Philipps University Marburg, Baldingerstrasse, Marburg, Germany. henzel@med.uni-marburg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Henzel
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamm
authors.forename: Helmut
authors.initials: H
authors.lastname: Sitter
authors.forename: Markus W
authors.initials: MW
authors.lastname: Gross
authors.forename: Gunnar
authors.initials: G
authors.lastname: Surber
authors.forename: Gabriele
authors.initials: G
authors.lastname: Kleinert
authors.forename: Rita
authors.initials: R
authors.lastname: Engenhart-Cabillic
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology / Q000532:radiotherapy*; D010347:Patient Care Planning; D011788:Quality of Life; D016634:Radiosurgery / Q000379:methods*; D013997:Time Factors