Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series
(1) Background: This study aimed to evaluate the efficacy and treatment-related toxicity of proton radiotherapy (PRT) for vestibular schwannoma (VS) in patients with neurofibromatosis type 2-related schwannomatosis (NF2). (2) Methods: Consecutive NF2 patients treated with PRT for VS between 2004 and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/3/263 |
| _version_ | 1797612501167243264 |
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| author | Jules P. J. Douwes Kimberley S. Koetsier Victor S. van Dam Scott R. Plotkin Frederick G. Barker D. Bradley Welling Jeroen C. Jansen Erik F. Hensen Helen A. Shih |
| author_facet | Jules P. J. Douwes Kimberley S. Koetsier Victor S. van Dam Scott R. Plotkin Frederick G. Barker D. Bradley Welling Jeroen C. Jansen Erik F. Hensen Helen A. Shih |
| author_sort | Jules P. J. Douwes |
| collection | DOAJ |
| description | (1) Background: This study aimed to evaluate the efficacy and treatment-related toxicity of proton radiotherapy (PRT) for vestibular schwannoma (VS) in patients with neurofibromatosis type 2-related schwannomatosis (NF2). (2) Methods: Consecutive NF2 patients treated with PRT for VS between 2004 and 2016 were retrospectively evaluated, focusing on tumor volume, facial and trigeminal nerve function, hearing, tinnitus, vestibular symptoms, and the need for salvage therapy after PRT. (3) Results: Eight patients were included (median age 36 years, 50% female). Median follow-up was 71 months. Five (63%) patients received fractionated PRT and three (38%) received PRT radiosurgery for VS. Six patients (75%) received prior VS surgery; three also received bevacizumab. Six patients (75%) did not require salvage therapy after PRT. Two patients (25%) with residual hearing lost it after PRT, and six had already lost ipsilateral hearing prior to PRT. Tumor and treatment-related morbidity could be evaluated in six patients. Following PRT, conditions that occurred or worsened were: facial paresis in five (83%), trigeminal hypoesthesia in two (33%), tinnitus in two (33%), and vestibular symptoms in four patients (67%). (4) Conclusion: After PRT for VS, the majority of the NF2 patients in the cohort did not require additional therapy. Tumor and/or treatment-related cranial nerve deficits were common. This is at least partly explained by the use of PRT as a salvage treatment after surgery or bevacizumab, in the majority of cases. There remains the further opportunity to elucidate the efficacy and toxicity of proton radiotherapy as a primary treatment. |
| first_indexed | 2024-03-11T06:42:07Z |
| format | Article |
| id | doaj.art-b4d64cf4638e4147b0e51ad30998698c |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T06:42:07Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-b4d64cf4638e4147b0e51ad30998698c2023-11-17T10:31:33ZengMDPI AGCurrent Oncology1198-00521718-77292023-03-013033473348310.3390/curroncol30030263Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case SeriesJules P. J. Douwes0Kimberley S. Koetsier1Victor S. van Dam2Scott R. Plotkin3Frederick G. Barker4D. Bradley Welling5Jeroen C. Jansen6Erik F. Hensen7Helen A. Shih8Department of Otorhinolaryngology—Head and Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Otorhinolaryngology—Head and Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Otorhinolaryngology—Head and Neck Surgery, Erasmus MC, 3015 GD Rotterdam, The NetherlandsDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USADepartment of Otorhinolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USADepartment of Otorhinolaryngology—Head and Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Otorhinolaryngology—Head and Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA(1) Background: This study aimed to evaluate the efficacy and treatment-related toxicity of proton radiotherapy (PRT) for vestibular schwannoma (VS) in patients with neurofibromatosis type 2-related schwannomatosis (NF2). (2) Methods: Consecutive NF2 patients treated with PRT for VS between 2004 and 2016 were retrospectively evaluated, focusing on tumor volume, facial and trigeminal nerve function, hearing, tinnitus, vestibular symptoms, and the need for salvage therapy after PRT. (3) Results: Eight patients were included (median age 36 years, 50% female). Median follow-up was 71 months. Five (63%) patients received fractionated PRT and three (38%) received PRT radiosurgery for VS. Six patients (75%) received prior VS surgery; three also received bevacizumab. Six patients (75%) did not require salvage therapy after PRT. Two patients (25%) with residual hearing lost it after PRT, and six had already lost ipsilateral hearing prior to PRT. Tumor and treatment-related morbidity could be evaluated in six patients. Following PRT, conditions that occurred or worsened were: facial paresis in five (83%), trigeminal hypoesthesia in two (33%), tinnitus in two (33%), and vestibular symptoms in four patients (67%). (4) Conclusion: After PRT for VS, the majority of the NF2 patients in the cohort did not require additional therapy. Tumor and/or treatment-related cranial nerve deficits were common. This is at least partly explained by the use of PRT as a salvage treatment after surgery or bevacizumab, in the majority of cases. There remains the further opportunity to elucidate the efficacy and toxicity of proton radiotherapy as a primary treatment.https://www.mdpi.com/1718-7729/30/3/263acoustic neuromacranial nervehearingneurofibromatosis type 2proton radiotherapyschwannomatosis |
| spellingShingle | Jules P. J. Douwes Kimberley S. Koetsier Victor S. van Dam Scott R. Plotkin Frederick G. Barker D. Bradley Welling Jeroen C. Jansen Erik F. Hensen Helen A. Shih Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series Current Oncology acoustic neuroma cranial nerve hearing neurofibromatosis type 2 proton radiotherapy schwannomatosis |
| title | Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series |
| title_full | Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series |
| title_fullStr | Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series |
| title_full_unstemmed | Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series |
| title_short | Proton Radiotherapy for Vestibular Schwannomas in Patients with NF2-Related Schwannomatosis: A Case Series |
| title_sort | proton radiotherapy for vestibular schwannomas in patients with nf2 related schwannomatosis a case series |
| topic | acoustic neuroma cranial nerve hearing neurofibromatosis type 2 proton radiotherapy schwannomatosis |
| url | https://www.mdpi.com/1718-7729/30/3/263 |
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