title: Stereotactic radiosurgery for non-vestibular cranial nerve schwanommas.
abstract: Non-vestibular cranial nerve schwannomas (NVCNS) are rare lesions, representing <10 % of cranial nerve schwannomas. The optimal treatment for NVCNS is often derived from vestibular schwannomas experience. Surgical resection has been referred to as the first line treatment for those benign tumors, but significant complication rates are reported. Stereotactic radiosurgery (SRS) has arisen as a mainstay of treatment for many benign tumors, including schwanommas. We retrospectively reviewed the outcomes of NVCNS treated by SRS to characterize tumor control, symptom relief, toxicity, and the role of hypo-fractionation of SRS dose. Eighty-eight (88) patients, with ninety-five (95) NVCNS were treated with either single or multi-session SRS from 2001 to 2014. Local control was achieved in 94 % of patients treated (median follow-up of 33 months, range 1-155). Complications were seen in 7.4 % of cases treated with SRS. At 1-year, 57 % of patients had improvement or resolution of their symptoms, while 35 % were stable and 8 % had worsening or increased symptoms. While 42 % received only one session, results on local control were similar for one or multiple sessions (p = 0.424). SRS for NVCNS is a treatment modality that provides excellent local control with minimal complication risk compared to traditional neurosurgical techniques. Tumor control obtained with a multi-session treatment was not significantly different from single session treatment. Safety profile was also comparable for uni or multi-session treatments. We concluded that, as seen in VS treated with CK SRS, radiosurgery treatment can be safely delivered in cases of NVCNS.
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA. myreille.dastous.1@ulaval.ca.|Department of Surgery, CHU de Québec, Université Laval, Quebec City, QC, Canada. myreille.dastous.1@ulaval.ca.
authors.forename: Myreille
authors.identifier: 0000-0002-6678-5483
authors.initials: M
authors.lastname: D'Astous
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Allen L
authors.initials: AL
authors.lastname: Ho
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Arjun
authors.initials: A
authors.lastname: Pendharkar
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Clara Y H
authors.initials: CY
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Scott G
authors.initials: SG
authors.lastname: Soltys
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Iris C
authors.initials: IC
authors.lastname: Gibbs
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Armine T
authors.initials: AT
authors.lastname: Tayag
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Thompson
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Adler
authors.affiliation: Department of Neurosurgery, Stanford University Medical Center, Stanford Cancer Institute, Stanford, CA, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003390:Cranial Nerve Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000401:mortality / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cranial nerve; Schwannoma; Stereotactic radiosurgery; Tumors