Stereotactic fractionated radiotherapy and LINAC radiosurgery in the treatment of vestibular schwannoma-report about both stereotactic methods from a single institution.
OBJECTIVE
To evaluate tumor control and side effects associated with radiosurgery (RS) and stereotactic fractionated radiotherapy (SFR) for vestibular schwannomas (VSs) in a group of patients treated at the same institution.


METHODS
Between May 1997 and June 2007, 115 consecutive cases of VS were treated in our department. The SFR group (47 patients), including larger tumors (maximum diameter >1.5 cm), received a total dose of 54 Gy at 1.8 Gy per fraction. The RS group (68 patients, maximum diameter <1.5 cm) received a total dose of 12 Gy at the 100% isodose. Evaluation included serial imaging tests (magnetic resonance imaging) and neurologic and functional hearing examinations.


RESULTS
The tumor control rate was 97.9% in the SFR group for a mean follow-up time of 32.1 months and 98.5% in the RS group for a mean follow-up time of 30.1 months. Hearing function was preserved after RS in 85% of the patients and after SFR in 79%. Facial and trigeminal nerve function remained mostly unaffected after SFR. After RS, new trigeminal neuropathy occurred in 9 of 68 patients (13%).


CONCLUSIONS
A high tumor control rate and low number of side effects are registered after SFR and RS of VS. These results confirm that considering tumor diameter, both RS and SFR are good treatment modalities for VS.
Kopp
Christine
C
Klinik und Poliklinik für Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar der Technische Universität München, Munich, Germany. Christine.Kopp@lrz.tu-muenchen.de
Fauser
Claudius
C
Müller
Axel
A
Astner
Sabrina T
ST
Jacob
Vesna
V
Lumenta
Christianto
C
Meyer
Bernhard
B
Tonn
Jörg-Christian
JC
Molls
Michael
M
Grosu
Anca-Ligia
AL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005154:Facial Nerve / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D014276:Trigeminal Nerve / Q000528:radiation effects; D020433:Trigeminal Nerve Diseases / Q000209:etiology; D047368:Tumor Burden