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Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and

R C Miller¹, R L Foote, R J Coffey

¹Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.

International Journal of Radiation Oncology, Biology, Physics

|February 25, 1999

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Reducing radiosurgical dose for acoustic neuromas significantly lowers facial nerve complications. A tumor margin dose of 16 Gy or less reduces the risk of permanent facial neuropathy after radiosurgery.

Area of Science:

Neurosurgery
Radiation Oncology
Neurology

Background:

Acoustic neuromas are tumors that develop on the nerve connecting the ear to the brain.
Radiosurgery is a common treatment for acoustic neuromas, but can cause cranial nerve complications.
Optimizing radiosurgical dose is crucial for balancing tumor control and minimizing side effects.

Purpose of the Study:

To evaluate if reducing the radiosurgical dose to acoustic neuromas can maintain tumor control while decreasing cranial nerve complications.
To identify specific dose thresholds associated with facial nerve complications.

Main Methods:

Prospective study comparing standard-dose and reduced-dose radiosurgery protocols for acoustic neuromas.
Dose protocols were based on tumor size (diameter or volume).

Related Experiment Videos

Kaplan-Meier actuarial incidence of facial and trigeminal neuropathy was calculated and analyzed.

Main Results:

Reduced-dose protocol showed a significantly lower incidence of facial neuropathy at 2 years (8% vs. 38%).
Tumor margin dose >= 18 Gy was the primary risk factor for facial nerve complications.
No tumor progression observed in the reduced-dose group during follow-up.

Conclusions:

A tumor margin dose of 16 Gy or less is associated with a significantly lower risk of permanent facial neuropathy.
Higher doses (>= 18 Gy) are linked to increased facial nerve complications.
Further follow-up is needed to confirm long-term tumor control with reduced doses.