title: Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.
abstract: Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS.
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Wenyin
authors.initials: W
authors.lastname: Shi
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
authors.forename: Varsha
authors.initials: V
authors.lastname: Jain
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States.
authors.forename: Colin
authors.initials: C
authors.lastname: Champ
authors.affiliation: Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Jain
authors.affiliation: Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Farrell
authors.affiliation: Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: David W
authors.initials: DW
authors.lastname: Andrews
authors.affiliation: Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Kevin
authors.initials: K
authors.lastname: Judy
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Haisong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Gregory
authors.initials: G
authors.lastname: Artz
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Maria
authors.initials: M
authors.lastname: Werner-Wasik
authors.affiliation: Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: James J
authors.initials: JJ
authors.lastname: Evans
keywords: facial nerve schwannoma; stereotactic radiotherapy