Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience
OBJECTIVE: To examine tumor control, hearing preservation, and complication rates after frameless fractionated stereotactic radiosurgery (SRS) in patients with vestibular schwannomas (VS).METHODS: Thirty seven patients treated with fractionated SRS from 2002 to 2011 were retrospectively analyzed. Ni...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2013-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00121/full |
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| author | Sana D Karam Alexander eTai Alexis eStrohl Matthew K Steehler Abdul eRashid Gregory eGagnon K. William eHarter Ann K Jay Sean P Collins Jeffrey H Kim Walter eJean |
| author_facet | Sana D Karam Alexander eTai Alexis eStrohl Matthew K Steehler Abdul eRashid Gregory eGagnon K. William eHarter Ann K Jay Sean P Collins Jeffrey H Kim Walter eJean |
| author_sort | Sana D Karam |
| collection | DOAJ |
| description | OBJECTIVE: To examine tumor control, hearing preservation, and complication rates after frameless fractionated stereotactic radiosurgery (SRS) in patients with vestibular schwannomas (VS).METHODS: Thirty seven patients treated with fractionated SRS from 2002 to 2011 were retrospectively analyzed. Ninety five percent were treated with 25 Gy in 5 fractions, targeting a median tumor volume of 1.03 cc (range 0.14-7.60). RESULTS: With a median follow-up of 4.25 years (range, 15months-9 years), no tumors required an additional treatment resulting in 100% tumor control rate. Radiographic control rate was 91% in 32 patients at a median follow-up of 3 years. Of the 14 patients with serviceable hearing and with audiograms, the hearing preservation rate was 78% at a median follow-up of 18 months. Twenty six patients with serviceable hearing pretreatment, were evaluated by a phone survey with a hearing preservation rate of 73% at a 5 year median follow-up. There were two cases that developed both new increased trigeminal parasthesias and facial spasms but there were no cases of facial weakness. Patient had 96% of good to excellent satisfaction rate with the treatment at a median follow-up of 5 years. CONCLUSION: Frameless fractionated SRS treatment of VS results in good rate of tumor control. Hearing preservation rate and rates of cranial nerve toxicity are comparable to what is reported in the literature. Patients choose this modality because of its non-invasive nature and are generally very satisfied with their long term outcome. |
| first_indexed | 2024-04-14T06:46:52Z |
| format | Article |
| id | doaj.art-b9da352c4886425a9030225e0c930772 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T06:46:52Z |
| publishDate | 2013-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-b9da352c4886425a9030225e0c9307722022-12-22T02:07:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2013-05-01310.3389/fonc.2013.0012149398Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution ExperienceSana D Karam0Alexander eTai1Alexis eStrohl2Matthew K Steehler3Abdul eRashid4Gregory eGagnon5K. William eHarter6Ann K Jay7Sean P Collins8Jeffrey H Kim9Walter eJean10Georgetown University HospitalGeorgetown University HospitalUniversity of RochesterGeorgetown University HospitalGeorgetown University HospitalFredrick Memorial HospitalGeorgetown University HospitalMedStar Georgetown University HospitalGeorgetown University HospitalGeorgetown University HospitalGeorgetown University HospitalOBJECTIVE: To examine tumor control, hearing preservation, and complication rates after frameless fractionated stereotactic radiosurgery (SRS) in patients with vestibular schwannomas (VS).METHODS: Thirty seven patients treated with fractionated SRS from 2002 to 2011 were retrospectively analyzed. Ninety five percent were treated with 25 Gy in 5 fractions, targeting a median tumor volume of 1.03 cc (range 0.14-7.60). RESULTS: With a median follow-up of 4.25 years (range, 15months-9 years), no tumors required an additional treatment resulting in 100% tumor control rate. Radiographic control rate was 91% in 32 patients at a median follow-up of 3 years. Of the 14 patients with serviceable hearing and with audiograms, the hearing preservation rate was 78% at a median follow-up of 18 months. Twenty six patients with serviceable hearing pretreatment, were evaluated by a phone survey with a hearing preservation rate of 73% at a 5 year median follow-up. There were two cases that developed both new increased trigeminal parasthesias and facial spasms but there were no cases of facial weakness. Patient had 96% of good to excellent satisfaction rate with the treatment at a median follow-up of 5 years. CONCLUSION: Frameless fractionated SRS treatment of VS results in good rate of tumor control. Hearing preservation rate and rates of cranial nerve toxicity are comparable to what is reported in the literature. Patients choose this modality because of its non-invasive nature and are generally very satisfied with their long term outcome.http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00121/fullRadiationCyberKnifeacoustic neuromavestibular schwannomafractionatedSRS |
| spellingShingle | Sana D Karam Alexander eTai Alexis eStrohl Matthew K Steehler Abdul eRashid Gregory eGagnon K. William eHarter Ann K Jay Sean P Collins Jeffrey H Kim Walter eJean Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience Frontiers in Oncology Radiation CyberKnife acoustic neuroma vestibular schwannoma fractionated SRS |
| title | Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience |
| title_full | Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience |
| title_fullStr | Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience |
| title_full_unstemmed | Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience |
| title_short | Frameless Fractionated Stereotactic Radiosurgery for Vestibular Schwannomas: A Single-Institution Experience |
| title_sort | frameless fractionated stereotactic radiosurgery for vestibular schwannomas a single institution experience |
| topic | Radiation CyberKnife acoustic neuroma vestibular schwannoma fractionated SRS |
| url | http://journal.frontiersin.org/Journal/10.3389/fonc.2013.00121/full |
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