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Clin Oncol (R Coll Radiol). 2013 Dec;25(12):734-8. doi: 10.1016/j.clon.2013.08.002. Epub 2013 Aug 22.

Fractionated stereotactic radiotherapy for acoustic neuromas: long-term outcomes.

Author information

1
Department of Oncology, Royal Free Hospital, London, UK. Electronic address: dwoolf@doctors.org.uk.

Abstract

AIMS:

Acoustic neuromas are rare, benign intracranial tumours. There are a variety of treatment options, with no clear optimal management strategy and wide variation in treated outcomes. We report the outcomes from a 15 year cohort of patients treated at our centre using fractionated stereotactic radiotherapy (52.5 Gy in 25 fractions).

MATERIALS AND METHODS:

We analysed a retrospective case series. Patients were identified from patient records and a retrospective review of case notes and imaging reports was undertaken. We assessed tumour response using RECIST criteria and recorded toxicity. Progression-free survival was estimated using the Kaplan-Meier method. The study was conducted according to the STROBE guidelines.

RESULTS:

In total, 93 patients were identified; 83 patients had follow-up data, with a median follow-up period of 5.7 years. The overall control rate using RECIST criteria was 92%. Data on complications were available for 90 patients, with six (7%) experiencing a reduction in hearing, one (1%) developing trigeminal nerve dysfunction and one (1%) a deterioration in facial nerve function. Other toxicities included four (4%) patients who developed hydrocephalus, requiring the placement of a shunt and one (1%) patient who developed radiation brainstem necrosis. After further evaluation this patient was deemed to have been treated within acceptable dose constraints.

CONCLUSION:

These data suggest that a good control rate of acoustic neuromas is achievable using fractionated stereotactic radiotherapy to a dose of 52.5 Gy in 25 fractions. Toxicity is considered acceptable but the episode of radiation brainstem necrosis remains of concern and is the subject of further work.

KEYWORDS:

Acoustic neuroma; outcomes; radio-necrosis; stereotactic radiotherapy; vestibular Schwannoma

PMID:
23973046
DOI:
10.1016/j.clon.2013.08.002
[Indexed for MEDLINE]

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