Radiobiology of vestibular schwannomas: mechanisms of radioresistance and potential targets for therapeutic sensitization.
Vestibular schwannomas (VS) are benign tumors arising from the Schwann cells of cranial nerve VIII. Historically the prevailing therapy for patients with VS has been microsurgical resection. More recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy have gained acceptance as effective alternatives. Although the side effect profile and rates of tumor control appear to be favorable for SRS, there is a subset of radioresistant tumors that continue to progress despite properly administered radiation treatment. In this review, the authors summarize what is known about the mechanism of radioresistance in VS at the clinical and molecular level. An improved understanding of the radiobiological behavior of VS may help guide appropriate patient selection for SRS and potentially aid in the design of novel therapies to treat radioresistant tumors.
Yeung
Andrea H
AH
Departments of Otolaryngology-Head and Neck Surgery, University of California at San Francisco, San Francisco, California, USA.
Sughrue
Michael E
ME
Kane
Ari J
AJ
Tihan
Tarik
T
Cheung
Steven W
SW
Parsa
Andrew T
AT
D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D018816:Genes, cdc / Q000502:physiology; D016158:Genes, p53 / Q000235:genetics / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008954:Models, Biological; D016518:Neurofibromatosis 2 / Q000532:radiotherapy / Q000601:surgery; D009464:Neuroma, Acoustic / Q000235:genetics / Q000532:radiotherapy* / Q000601:surgery*; D011829:Radiation Dosage; D011836:Radiation Tolerance / Q000235:genetics / Q000502:physiology*; D011853:Radiobiology; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D000159:Vestibulocochlear Nerve / Q000528:radiation effects / Q000601:surgery