Stereotactic Radiosurgery for Vestibular Schwannomas

2011 ◽  
Vol 32 (5) ◽  
pp. 834-837 ◽  
Author(s):  
Michael A. German ◽  
Shawn Zardouz ◽  
Mehdi K. Sina ◽  
Kasra Ziai ◽  
Hamid Reza Djalilian
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas

Medium Term Outcome of LINAC-Based Stereotactic Radiosurgery for Vestibular Schwannomas with Marginal Dose of 12.5 Gy

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
J. Ellenbogen ◽  
A. Kinshuck ◽  
M. Jenkinson ◽  
T. Lesser ◽  
D. Husband ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas ◽  
Medium Term ◽  
Term Outcome

scholarly journals Biologically effective dose correlates with linear tumor volume changes after upfront single-fraction stereotactic radiosurgery for vestibular schwannomas

2021 ◽  
Author(s):  
Constantin Tuleasca ◽  
Mohamed Faouzi ◽  
Philippe Maeder ◽  
Raphael Maire ◽  
Jonathan Knisely ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Effective Dose ◽  
Stereotactic Radiosurgery ◽  
Tumor Volume ◽  
Vestibular Schwannomas ◽  
Benign Tumors ◽  
Biologically Effective Dose ◽  
Volume Changes ◽  
Single Fraction

AbstractVestibular schwannomas (VSs) are benign, slow-growing tumors. Management options include observation, surgery, and radiation. In this retrospective trial, we aimed at evaluating whether biologically effective dose (BED) plays a role in tumor volume changes after single-fraction first intention stereotactic radiosurgery (SRS) for VS. We compiled a single-institution experience (n = 159, Lausanne University Hospital, Switzerland). The indication for SRS was decided after multidisciplinary discussion. Only cases with minimum 3 years follow-up were included. The Koos grading, a reliable method for tumor classification was used. Radiosurgery was performed using Gamma Knife (GK) and a uniform marginal prescription dose of 12 Gy. Mean BED was 66.3 Gy (standard deviation 3.8, range 54.1–73.9). The mean follow-up period was 5.1 years (standard deviation 1.7, range 3–9.2). The primary outcome was changes in 3D volumes after SRS as function of BED and of integral dose received by the VS. Random-effect linear regression model showed that tumor volume significantly and linearly decreased over time with higher BED (p < 0.0001). Changes in tumor volume were also significantly associated with age, sex, number of isocenters, gradient index, and Koos grade. However, the effect of BED on tumor volume change was moderated by time after SRS and Koos grade. Lower integral doses received by the VSs were inversely correlated with BED in relationship with tumor volume changes (p < 0.0001). Six (3.4%) patients needed further intervention. For patients having uniformly received the same marginal dose prescription, higher BED linearly and significantly correlated with tumor volume changes after SRS for VSs. BED could represent a potential new treatment paradigm for patients with benign tumors, such as VSs, for attaining a desired radiobiological effect. This could further increase the efficacy and decrease the toxicity of SRS not only in benign tumors but also in other SRS indications.

The Outcome of Hypofractionated Stereotactic Radiosurgery for Large Vestibular Schwannomas

2016 ◽  
Vol 93 ◽  
pp. 398-409 ◽  
Author(s):  
Mario Teo ◽  
Michael Zhang ◽  
Amy Li ◽  
Patricia A. Thompson ◽  
Armine T. Tayag ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas ◽  
Hypofractionated Stereotactic Radiosurgery

Stereotactic radiosurgery as the first-line treatment for intracanalicular vestibular schwannomas

2021 ◽  
pp. 1-7
Author(s):  
Akiyoshi Ogino ◽  
L. Dade Lunsford ◽  
Hao Long ◽  
Stephen Johnson ◽  
Andrew Faramand ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Observation Interval ◽  
Univariate Analysis ◽  
Hearing Preservation ◽  
Vestibular Schwannomas ◽  
Tumor Control ◽  
Line Treatment ◽  
First Line ◽  
Additional Intervention ◽  
First Line Treatment

OBJECTIVEThis report evaluates the outcomes of stereotactic radiosurgery (SRS) as the first-line treatment of intracanalicular vestibular schwannomas (VSs).METHODSBetween 1987 and 2017, the authors identified 209 patients who underwent SRS as the primary intervention for a unilateral intracanalicular VS. The median patient age was 54 years (range 22–85 years); 94 patients were male and 115 were female. Three patients had facial neuropathy at the time of SRS. One hundred fifty-five patients (74%) had serviceable hearing (Gardner-Robertson [GR] grades I and II) at the time of SRS. The median tumor volume was 0.17 cm3 (range 0.015–0.63 cm3). The median margin dose was 12.5 Gy (range 11.0–25.0 Gy). The median maximum dose was 24.0 Gy (range 15.7–50.0 Gy).RESULTSThe progression-free survival rates of all patients with intracanalicular VS were 97.5% at 3 years, 95.6% at 5 years, and 92.1% at 10 years. The rates of freedom from the need for any additional intervention were 99.4% at 3 years, 98.3% at 5 years, and 98.3% at 10 years. The serviceable hearing preservation rates in GR grade I and II patients at the time of SRS were 76.6% at 3 years, 63.5% at 5 years, and 27.3% at 10 years. In univariate analysis, younger age (< 55 years, p = 0.011), better initial hearing (GR grade I, p < 0.001), and smaller tumor volumes (< 0.14 cm3, p = 0.016) were significantly associated with improved hearing preservation. In multivariate analysis, better hearing (GR grade I, p = 0.001, HR 2.869, 95% CI 1.569–5.248) and smaller tumor volumes (< 0.14 cm3, p = 0.033, HR 2.071, 95% CI 1.059–4.047) at the time of SRS were significantly associated with improved hearing preservation. The hearing preservation rates of patients with GR grade I VS were 88.1% at 3 years, 77.9% at 5 years, and 38.1% at 10 years. The hearing preservation rates of patients with VSs smaller than 0.14 cm3 were 85.5% at 3 years, 77.7% at 5 years, and 42.6% at 10 years. Facial neuropathy developed in 1.4% from 6 to 156 months after SRS.CONCLUSIONSSRS provided sustained tumor control in more than 90% of patients with intracanalicular VS at 10 years and freedom from the need for additional intervention in more than 98% at 10 years. Patients with initially better hearing and smaller VSs had enhanced serviceable hearing preservation during an observation interval up to 10 years after SRS.

Stereotactic Radiosurgery as Primary Treatment in Fast-Growing Vestibular Schwannomas: A Meta-analysis

2021 ◽  
Author(s):  
Leanne O. Hamilton ◽  
Constantina Yiannakis ◽  
Afiq Slim ◽  
Georgios Kontorinis
Keyword(s):  
Stereotactic Radiosurgery ◽  
Meta Analysis ◽  
Primary Treatment ◽  
Vestibular Schwannomas ◽  
Fast Growing

scholarly journals Long-Term Hearing Outcomes following Stereotactic Radiosurgery in Patients with Vestibular Schwannomas

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Peter Santa Maria ◽  
Yangyang Shi ◽  
Richard Gurgel ◽  
Carleton Corrales ◽  
Scott Soltys ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas ◽  
Hearing Outcomes

Audiological Outcomes in Growing Vestibular Schwannomas Managed Either Conservatively, or With Stereotactic Radiosurgery

2018 ◽  
Vol 39 (2) ◽  
pp. e143-e150 ◽  
Author(s):  
Thomas Daniel Milner ◽  
Richard R. Locke ◽  
Georgios Kontorinis ◽  
John A. Crowther
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas

Hearing Outcomes After Stereotactic Radiosurgery for Vestibular Schwannomas

2016 ◽  
pp. 3-36 ◽  
Author(s):  
Jung Ho Han ◽  
Dong Gyu Kim ◽  
Hyun-Tai Chung ◽  
Sun Ha Paek ◽  
Hee-Won Jung
Keyword(s):  
Stereotactic Radiosurgery ◽  
Vestibular Schwannomas ◽  
Hearing Outcomes
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