Abstract
BackgroundHerein, we report clinical results for patients treated with stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) over a period of 10 years.MethodsClinical data and imaging follow-up were stored in a database of 1,378 patients, with 1,384 VS treated consecutively between 2005 and 2018 and analyzed retrospectively. A total of 996 patients with 1,002 tumors with at least one year of follow-up were included for analysis.ResultsMedian follow-up was 3·6 years (1-12·5 years). The three, five, and 10-year Kaplan-Meier estimated local tumor control was 96·6%, 92·3%, and 90·8%, respectively. The median hearing loss of the affected ear as compared to its healthy counterpart was 17 dB at treatment start and increased to 23 and 29 dB at one and five years. Six patients (0·6%) developed symptomatic hydrocephalus and underwent the placement of a ventriculoperitoneal shunt. In 30 patients (3·0%), trigeminal sensory dysfunction developed, five patients (0·5%) had a mild transient weakness, and nine patients (0·9%) had a permanent facial weakness (House-Brackmann Grade > II) after SRS.ConclusionSingle fraction SRS proves to be highly effective and shows low treatment-related toxicity for VS. SRS should be considered a primary treatment option for small and middle-sized VS.
Highlights
Stereotactic radiosurgery (SRS) becomes increasingly popular for mostly small vestibular schwannomas (VS) due to its treatment efficiency and ease of use as compared to surgical tumor resection
We report clinical results for patients treated with stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) over a period of 10 years
Long-term data with reasonably large patient cohorts are missing and few quality-of-life evaluations after SRS for VS have been presented to date [1,2]
Summary
Stereotactic radiosurgery (SRS) becomes increasingly popular for mostly small vestibular schwannomas (VS) due to its treatment efficiency and ease of use as compared to surgical tumor resection. Long-term data with reasonably large patient cohorts are missing and few quality-of-life evaluations after SRS for VS have been presented to date [1,2]. Most published series comprise smaller heterogeneous patient groups treated with inconsistent radiosurgical techniques and doses [3,4,5]. The purpose of this study was to analyze the functional outcome and the local tumor control after SRS for VS of a large patient group treated with the same technique in a dedicated treatment center over a period of 10 years. We report clinical results for patients treated with stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) over a period of 10 years
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