Abstract
<h3>Purpose/Objective(s)</h3> Prior studies have reported favorable local control for patients treated with Gamma Knife (GK) or linear accelerator (LINAC)-based radiosurgery (SRS); however, direct comparison of detailed patient-reported quality of life (QOL) outcomes are lacking. This multi-center retrospective review assessed for differences in QOL outcomes and toxicity profiles after radiotherapy for acoustic neuromas in patients treated with GK and LINAC-based radiosurgery. <h3>Materials/Methods</h3> In this multi-center single institution analysis, we retrospectively reviewed acoustic neuroma cases treated with either GK or LINAC-based SRS between 2008-2017. We compared pre- and post- treatment clinical outcomes including new development of tinnitus, vertigo, gait disturbance, facial palsy, hydrocephalus and audiometric data. We also collected radiographic and dosimetric information including tumor size and dose to cochlea. Descriptive statistics were performed and χ<sup>2</sup> was utilized to assess for intergroup differences in clinicoradiographic or dosimetric differences. Univariate and multivariate multinomial logistic regression analyses were performed with backward selection at alpha of 0.2 to assess for statistically significant associations with the development of the clinical endpoints described above. <h3>Results</h3> A total of 85 patients were included in our review, 36 in the GK group and 49 in the LINAC-SRS group. 39 patients were male (45.9%) and 46 female (54.1%), 45 were left-sided tumors (52.9%) and 40 right-sided tumors (47.1%). All patients were treated with single-fraction SRS, with a prescription of 12.5 Gy for GK and 12 Gy for LINAC-based SRS. Median follow up was 25 months (median 21 months in GK group, 26 months in LINAC group). On multivariate analysis, there was no significant difference in the development of post-treatment tinnitus, vertigo, gait disturbance, facial palsy, hydrocephalus, change in Gardner Robertson Grade, or change in hearing between the GK and LINAC treatment groups (p> 0.05). Similarly, multivariate analysis did not show tumor size or cochlear dose to be associated with development of specific toxicities between treatment modalities (p>0.05). <h3>Conclusion</h3> This multi-center retrospective review found no significant differences in patient-reported QOL outcomes for patients treated with either Gamma Knife or LINAC-based radiosurgery for acoustic neuromas. This study adds to the body of evidence that both modalities are feasible approaches with similar toxicity profiles for the treatment of acoustic neuromas, and patients can be counselled as such.
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