Long-term outcome of gamma knife radiosurgery for vestibular schwannoma.

Abstract

Objective We evaluated the long-term outcome of vestibular schwannoma (VS) treated with gamma knife radiosurgery (GKRS) as a primary treatment as well as an adjunct therapy. Materials and Methods We performed a retrospective review (2000-2012) of 82 patients with VS who received GKRS. Of 82 patients, 20 patients with prior resection received GKRS treatment as an adjunct therapy. The remainder of the patients (62) received GKRS as a primary treatment. Results GKRS for VS showed significant variations in tumor growth control (decreased in 44 patients [54%], arrested growth in 30 patients [36%], and increased tumor size in 8 patients [10%]). Progression-free survival rates after GKRS at 3, 5, and 10 years were 98%, 95%, and 95%, respectively. Hearing, facial nerve function, and Karnofsky performance scale were significantly improved after GKRS compared with pretreated status (79 versus 90). Two patients (2.5%) required resection again due to tumor progression and worsening of signs and symptoms. Conclusion Long-term follow-up demonstrated that GKRS offers a high rate of tumor control, preservation of multiple nerve functions, and a good quality of life in both new and recurrent patients with VS.