title: Linear accelerator radiosurgery for nonvestibular schwannomas.
abstract: BACKGROUND
  Nonvestibular schwannomas are uncommon tumors of the brain often treated by surgical resection. Surgery may be associated with high morbidity.
  
  
  OBJECTIVE
  We present a series of nonvestibular schwannomas treated with linear accelerator radiosurgery during a 19-year period.
  
  
  METHODS
  This is a retrospective analysis of patients who underwent treatment of nonvestibular schwannomas at the University of Florida with linear accelerator radiosurgery between August 1989 and February 2008. Forty-nine patients underwent treatment during the study period, and 6 were lost to follow up. The mean age was 51 years (range, 17-82 years), 39% had previous surgical resection, and 67% presented with preradiosurgery cranial nerve deficits. There were 25 trigeminal, 18 jugular foramen, 2 facial, 2 oculomotor, 1 hypoglossal, and 1 high cervical schwannomas. The median tumor volume was 5.3 mL (range, 0.3-24.5 mL), treated with a median dose of 1250 cGy (range, 1000-1500 cGy). Study endpoints were actuarial local tumor control and neurological outcome.
  
  
  RESULTS
  Forty-three patients were available for a median follow-up of 37 months (range, 6-210 months). Actuarial local tumor control was 97% at 1 year, 91% at 4.5 years, and 83% at 5 years. There were 4 new cranial nerve deficits (9%) including facial numbness (2 patients), anesthesia dolorosa (1 patient), and facial weakness (1 patient). Thirty-nine percent had documented clinical and/or symptomatic improvement. There were no other morbidity and no mortality with treatment.
  
  
  CONCLUSIONS
  Radiosurgery for nonvestibular schwannomas offers good actuarial local tumor control and has superior morbidity compared with surgical resection. This is the largest linear accelerator radiosurgical series, and the second largest radiosurgical series reported to date.
authors.affiliation: Department of Neurosurgery, University of Florida, Gainesville, Florida 32610, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Kimball
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Bova
authors.forename: Yueh-Yun
authors.initials: YY
authors.lastname: Chi
authors.forename: William A
authors.initials: WA
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult