Hearing preservation following fractionated stereotactic radiotherapy for vestibular schwannomas: prognostic implications of cochlear dose

Thomas, C.; Maio, Salvatore Di; Ma, Ruijuan; Vollans, E.; Chu, Christina; M.Math.,; Clark, Brenda; Lee, Richard; McKenzie, Michael; Martin, Montgomery; Toyota, Brian

doi:10.3171/jns.2007.107.5.917

Cited by 14 publications

(19 citation statements)

References 48 publications

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“…[25][26][27] Although we observed no significant effect of cochlear doses in the current study, this issue deserves further investigation in a larger series.…”

Section: Discussioncontrasting

confidence: 42%

Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Phi¹,

Kim²,

Chung³

et al. 2009

Cancer

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BACKGROUND:The radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2 (NF2) is controversial. The authors investigated the radiologically proven tumor control rate after gamma knife radiosurgery. The factors that affect tumor control and serviceable hearing preservation were analyzed.METHODS:Thirty‐six lesions in 30 patients were included. The median lengths of the clinical and radiologic follow‐ups were 48.5 months and 36.5 months, respectively. The median tumor volume was 3.2 cm3. The mean marginal dose was 12.1 grays (Gy) (range, 8–14 Gy) at an isodose line of 50%±0.6%. The Kaplan‐Meier method and Cox proportional hazards model were used for the statistical analyses.RESULTS:The actuarial tumor control rate was 81%, 74%, and 66%, respectively, in the first, second, and fifth years. Five tumors required a salvage surgery because of tumor control failure. A low marginal dose and a young age at radiosurgery were associated with poor tumor control. Of the 16 tumors with which ipsilateral hearing was serviceable, the actuarial serviceable hearing preservation rates were 50%, 45%, and 33%, respectively, in the first, second, and fifth years. Better ipsilateral hearing (Gardner‐Robertson grade 1, compared with grade 2) at the time of radiosurgery was associated with significantly greater serviceable hearing preservation.CONCLUSIONS:Gamma knife radiosurgery for vestibular schwannomas in NF2 patients provided 5‐year tumor control in approximately two‐thirds of patients and preserved serviceable hearing in approximately one‐third. The rates of other cranial nerve deficits were low, and no secondary malignancy was observed. Radiosurgery should be included in treatment options for NF2 patients. Cancer 2009. © 2009 American Cancer Society.

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“…[25][26][27] Although we observed no significant effect of cochlear doses in the current study, this issue deserves further investigation in a larger series.…”

Section: Discussioncontrasting

confidence: 42%

Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Phi¹,

Kim²,

Chung³

et al. 2009

Cancer

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“…Fractionation seems to increase latency for late toxicity rather than reduce its incidence. 16 A retrospective analysis conducted at the Royal Free Hospital from a 15 year cohort of 93 patients treated with FSRT (52.5 Gy in 25 fractions) obtained an overall control rate of 92%. Data on complications were available for 90 patients, with 7% experiencing a reduction in hearing, 1% developing trigeminal nerve dysfunction and 1% a deterioration in facial nerve function.…”

Section: Fractionated Stereotactic Radiotherapy (Fsrt)mentioning

confidence: 98%

“…Local control with this approach was high (90-100%) but a significant number of adverse effects were observed, first of all hearing loss. 7-10 Foote et al treated 36 patients with acoustic neuromas with SRS using a gamma knife at a dose of [16][17][18][19][20] Gy to the tumour margin. No tumour progression was observed, but the 2-year actuarial rate of preservation of useful hearing was only 41.7%, and the 2-year actuarial incidence of facial or trigeminal neuropathy was 81.7%.…”

Section: Stereotactic Radio-surgery (Srs)mentioning

confidence: 99%

Radiotherapy for vestibular schwannoma: Review of recent literature results

Apicella

Paolini

Deantonio

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…Linskey et al 10 noted that the dose typically delivered to the middle ear was low, but that the inner ear and infratemporal facial nerve doses must be planned carefully. Thomas et al 16 found that the radiation dose received by the cochlea was strongly predictive of hearing deterioration after fractionated radiotherapy. Beegle et al 1 concluded that the dose was more important than conformality in the prevention of facial or trigeminal nerve deficits.…”

Section: Neurosurg Focus / Volume 24 / May 2008mentioning

confidence: 99%

The principles of skull base radiosurgery

Kondziolka¹,

Flickinger

Lunsford³

2008

FOC

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✓ Stereotactic radiosurgery is commonly used for selected patients with benign cranial base tumors. The goal of radiosurgery is cessation of tumor growth and preservation of neurological function. Over the last 2 decades, the technique of radiosurgery has evolved due to improved imaging, better radiosurgical devices and software, and the continued analysis of results. In this report, the authors discuss technical concepts and dose selection in skull base radiosurgery.

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Hearing preservation following fractionated stereotactic radiotherapy for vestibular schwannomas: prognostic implications of cochlear dose

Cited by 14 publications

References 48 publications

Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Radiotherapy for vestibular schwannoma: Review of recent literature results

The principles of skull base radiosurgery

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