Long-Term Outcomes of Stereotactic Radiosurgery for Trigeminal, Facial, and Jugular Foramen Schwannoma in Comparison with Vestibular Schwannoma.

Yuki Shinya,Masahiro Shin,Nobuhito Saito,Kenji Kondo,Atsuto Katano,Hirotaka Hasegawa,Mariko Kawashima,Takehiro Sugiyama,Akinori Kashio

doi:10.3390/cancers13051140

Abstract

Simple SummaryIntracranial schwannomas are benign intracranial neoplasms. Vestibular schwannomas (VS) account for 90% of intracranial schwannomas; whereas the other cranial nerve schwannomas, such as trigeminal (TS), facial (FS), and jugular foramen schwannoma (JFS), account for 10% of all cases. Stereotactic radiosurgery (SRS) is a minimally invasive treatment for small to medium VS and known to provide excellent long-term tumor control; however, there remains a paucity of evidence regarding SRS for TS, FS, and JFS due to the rarity of these tumors. We investigated the radiosurgical outcomes of these non-vestibular schwannomas and compared them to those of VS through matched cohort analysis.Stereotactic radiosurgery (SRS) is known to provide excellent tumor control with functional preservation for vestibular schwannomas (VS), but its efficacy in the other major intracranial schwannomas including trigeminal (TS), facial (FS), and jugular foramen schwannomas (JFS) has not been established yet due to their rarity. We retrospectively analyzed data of 514 consecutive patients who had intracranial schwannomas (460 VS, 22 TS, 7 FS, and 25 JFS) and underwent SRS. The 5- and 10-year tumor control rates were 97% and 94% for VS, 100% and 100% for TS, 80% and 80% for FS, and 100% and 80% for JFS. Radiation-induced complications included one hydrocephalus for TS (4.5%), no cases for FS (0%), and one hydrocephalus and one lower palsy for JFS (8.0%). Through matched cohort analysis between patients with VS and each of the non-VS, we found no statistical difference in tumor control and radiation-induced adverse events. SRS seems to provide long-term tumor control with functional preservation for TS, FS and JFS and the efficacies are similar to VS.

Highlights

Intracranial schwannomas are the third most common benign neoplasms that are thought to arise from Schwann cells and account for 6–12.3% of all intracranial tumors [1,2,3]
514 patients were included in this study (460 vestibular schwannoma (VS), 22 treatment results (TS), 7 facial schwannoma (FS), and 25 jugular foramen schwannoma (JFS))
The observation period was significantly shorter in the JFS group than the VS group

Summary

Introduction

Intracranial schwannomas are the third most common benign neoplasms that are thought to arise from Schwann cells and account for 6–12.3% of all intracranial tumors [1,2,3]. Given the robust evidence demonstrating favorable long-term tumor control for VS and the similar cellular origin and benignity, SRS is expected to provide a similar level of efficacy for TS, FS, and JFS [15]. Several studies have described the outcomes of SRS for non-VS, the numbers of patients are limited, and those studies may be susceptible to biases, leading to suboptimal external validity [2,6,9,16,17,18,19,20]. In multicenter studies for such rare tumors, inter-hospital diversities in treatment policies and radiosurgical doses might hinder the outcomes and interpretation. These studies may not be enough to address long-term outcomes. There remains a paucity of data on the long-term efficacy of SRS for TS, FS, and JFS

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