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Strahlenther Onkol. 2017 Mar;193(3):200-212. doi: 10.1007/s00066-016-1086-5. Epub 2016 Dec 7.

Stereotactic radiotherapy of vestibular schwannoma : Hearing preservation, vestibular function, and local control following primary and salvage radiotherapy.

Author information

1
Department of Radiation Oncology, Friedrich-Alexander-University Erlangen-Nuremberg, Universitaetsstraße 27, 91054, Erlangen, Germany. florian.putz@uk-erlangen.de.
2
Department of Radiation Oncology, Friedrich-Alexander-University Erlangen-Nuremberg, Universitaetsstraße 27, 91054, Erlangen, Germany.
3
Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany.
4
Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.

Abstract

OBJECTIVE:

The aim of this publication is to present long-term data on functional outcomes and tumor control in a cohort of 107 patients treated with stereotactic radiotherapy (RT) for vestibular schwannoma.

PATIENTS AND METHODS:

Included were 107 patients with vestibular schwannoma (primary or recurrent following resection) treated with stereotactic RT (either fractioned or single-dose radiosurgery) between October 2002 and December 2013. Local control and functional outcomes were determined. Analysis of hearing preservation was limited to a subgroup of patients with complete audiometric data collected before treatment and during follow-up. Vestibular function test (FVT) results could be analyzed in a subset of patients and were compared to patient-reported dizziness.

RESULTS:

After a mean follow-up of 46.3 months, actuarial local control for the whole cohort was 100% after 2, 97.6% after 5, and 94.1% after 10 years. In patients with primary RT, serviceable hearing was preserved in 72%. Predictors for preservation of serviceable hearing in multivariate analysis were time of follow-up (odds ratio, OR = 0.93 per month; p = 0.021) and pre-RT tumor size (Koos stage I-IIa vs. IIb-IV; OR = 0.15; p = 0.031). Worsening of FVT results was recorded in 17.6% (N = 3). Profound discrepancy of patient-reported dizziness and FVT results was observed after RT. In patients with primary RT, worsening of facial nerve function occurred in 1.7% (N = 1).

CONCLUSION:

Stereotactic RT of vestibular schwannoma provides good functional outcomes and high control rates. Dependence of hearing preservation on time of follow-up and initial tumor stage has to be considered.

KEYWORDS:

Audiometry; Dizziness; Hearing loss; Radiosurgery; Vestibular function tests

PMID:
27928625
DOI:
10.1007/s00066-016-1086-5
[Indexed for MEDLINE]

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