Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: The Greek experience

Kalogeridi, Maria-Aggeliki; Georgolopoulou, P.; Kouloulias, Vassilis; Kouvaris, John; Pissakas, George

doi:10.4103/0973-1482.48764

Cited by 22 publications

(11 citation statements)

References 27 publications

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“…Much remains unclear regarding the long-term effects of SRS for tumor treatment, therefore we used 3D-SPGR MRI to measure tumor volumes. In many studies, imaging evaluations have been performed using two-dimensional (2D) measurements, and enlargement has often been defined as an increase of at least 2 mm in the maximum tumor diameter [17][18][19][20]. However, the 3D evaluations that we used resulted in fewer measurement errors than the 2D method, and is particularly useful when determining VS control, given that VS enlarges in multiple directions [21].…”

Section: Discussionmentioning

confidence: 95%

Long-term follow-up results of linear accelerator-based radiosurgery for vestibular schwannoma using serial three-dimensional spoiled gradient-echo MRI

Matsuo

Okunaga

Kamada

et al. 2015

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 95%

Long-term follow-up results of linear accelerator-based radiosurgery for vestibular schwannoma using serial three-dimensional spoiled gradient-echo MRI

Matsuo

Okunaga

Kamada

et al. 2015

Journal of Clinical Neuroscience

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“…Numerous reports (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) of the long-term outcomes after SRS using marginal tumor doses of 12-13 Gy ( Fig. 1), with excellent progression-free survival (range, 92-100%), have been published (Table 3).…”

Section: Single-session Srsmentioning

confidence: 97%

“…Some institutions used MRI-based planning (27,30,31,33,34,38), others used a combination of computed tomography and MRI (28,29,35,37,39), and only one used contrast-enhanced computed tomography alone (32). With these lower SRS doses and MRI-based treatment plans, permanent preservation of the trigeminal nerve and facial nerve has been possible in 92-100% and 94-100% of the cases, respectively (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). In addition, the use of multiple isocenters has improved conformality, allowing for precise coverage of irregularly shaped VSs and decreasing the radiation dose to the CNs and normal brain tissue (29,30).…”

Section: Single-session Srsmentioning

confidence: 99%

“…No other dosimetric variables, including the dose to the cochlear nucleus, correlated with hearing preservation. From the 13 studies reviewed for modern SRS results, only 2 groups(28,32) report the delineation of organs at risk during treatment planning. Only 3(52,57,60) of the 10 studies of long-term results of FSRT discussed contouring organs at risk as a part of their treatment planning.…”

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confidence: 99%

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Radiotherapy for Vestibular Schwannomas: A Critical Review

Murphy

Suh

2011

International Journal of Radiation Oncology*Biology*Physics

166

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“…Since the publication of Leksell's 1971 report,7 numerous efforts have been made to increase the tumor control rate and reduce the risk of cranial nerve injury. Consequently, many reports on long‐term outcomes after SRS for VS indicated not only excellent progression‐free survival rates of 92% to 100% but also outstanding preservation of the trigeminal nerve and facial nerve in 92% to 100% and 94% to 100% of patients, respectively, even with the lower marginal tumor doses of 12 to 13 grays (Gy) 4, 8‐18. However, hearing preservation still falls short of our expectations; the range after SRS with long‐term follow‐up has been reported as 32% to 71% 3, 4, 8, 10‐13, 15‐19…”

Section: Introductionmentioning

confidence: 80%

Hearing preservation in patients with unilateral vestibular schwannoma who undergo stereotactic radiosurgery

Han¹,

Kim²,

Chung³

et al. 2012

Cancer

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BACKGROUND:The objective of this study was to identify the prognostic factors for hearing preservation that would allow the more accurate stratification of patients who undergo stereotactic radiosurgery (SRS) for unilateral, sporadic vestibular schwannoma (VS). METHODS: In total, 119 patients with VS who had serviceable hearing underwent SRS as primary treatment. The mean (AEstandard deviation) patient age was 48 AE 11 years, and the mean (AEstandard deviation) follow-up duration was 55.2 AE 35.7 months. The median marginal radiotherapy dose was 12.0 grays (Gy), and the mean (AEstandard deviation) tumor volume was 1.95 AE 2.24 cm 3 . The mean (AEstandard deviation) pure tone average (PTA) score was 26 AE 12 decibels (dB) (range, 4-50 dB), and the mean (AEstandard deviation) maximum speech discrimination score was 91 AE 12% (range, 52-100%). The mean (AEstandard deviation) baseline values for the interlatency (IL) of waves I and III (IL I-III) and the IL of waves I through V (IL I-V) on auditory brainstem response were 2.58 AE 0.60 milliseconds (mS) (range, 1.92-4.30 mS) and 4.80 AE 0.61 mS (range, 3.80-6.40 mS), respectively. RESULTS: In multivariate analysis, the PTA score and IL I-V were significant and independent prognostic factors (hazard ratio, 1.072; 95% confidence interval, 1.046-1.098; P < .001; and hazard ratio, 1.534; 95% confidence interval, 1.008-2.336; P ¼ .046, respectively). By using the PTA score and IL I-V, the patients were classified into 4 groups. The ratios of patients with serviceable hearing after SRS were 89.6%, 64.0%, 25.8%, and 6.7%, respectively, in Groups A through D (P < .001). CONCLUSIONS: The current results indicated that the classification system based on using the PTA score and the IL I-V of the auditory brainstem response may be useful and specific for predicting the rate of hearing preservation in each individual. Cancer 2012;118:5441-7. V C 2012 American Cancer Society.KEYWORDS: radiosurgery, vestibular schwannoma, hearing preservation, classification system, auditory brainstem response. INTRODUCTIONIn 1988, Gardner and Robertson described a classification system for predicting hearing preservation in patients who underwent surgery for unilateral vestibular schwannoma (VS). 1 This system, called the Gardner-Robertson classification system (G-R classification), is simple, straightforward, and can be performed from memory. Thus, the G-R classification also has been useful for classifying hearing levels both before and after stereotactic radiosurgery (SRS) for VS, 2-5 although this system was based on the results from a surgical series of patients with VS.SRS was first designed in 1951 by Lars Leksell, 6 and the use of SRS was expanded to include the treatment of VS in 1969. 7 Since the publication of Leksell's 1971 report, 7 numerous efforts have been made to increase the tumor control rate and reduce the risk of cranial nerve injury. Consequently, many reports on long-term outcomes after SRS for VS indicated not only excellent progression-free survival rates of 92% to 100% bu...

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Long-term results of LINAC-based stereotactic radiosurgery for acoustic neuroma: The Greek experience

Abstract: LINAC-based SRS with 11-12 Gy provides excellent tumor control in acoustic neuroma and has low toxicity even after long-term follow-up.

Cited by 22 publications

References 27 publications

Long-term follow-up results of linear accelerator-based radiosurgery for vestibular schwannoma using serial three-dimensional spoiled gradient-echo MRI

Long-term follow-up results of linear accelerator-based radiosurgery for vestibular schwannoma using serial three-dimensional spoiled gradient-echo MRI

Radiotherapy for Vestibular Schwannomas: A Critical Review

Hearing preservation in patients with unilateral vestibular schwannoma who undergo stereotactic radiosurgery

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