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Reduced-dose radiosurgery for vestibular schwannomas.
J H Petit1, R S Hudes, T T Chen
1Department of Neurological Surgery, University of Maryland Medical Center, Baltimore, Maryland 21201-1595, USA. jpetit001@maryland.edu
Neurosurgery
|February 16, 2002
Summary
Low-dose gamma knife radiosurgery effectively controlled vestibular schwannomas in 96% of patients, with minimal complications. This treatment preserves hearing in most patients with early-stage hearing loss.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Vestibular schwannomas are tumors that develop on the nerve connecting the ear to the brain.
- Radiosurgery offers a minimally invasive treatment option for these tumors.
Purpose of the Study:
- To evaluate tumor control and complications of low-dose radiosurgery for vestibular schwannomas.
- To determine the efficacy of gamma knife radiosurgery in managing these tumors.
Main Methods:
- 47 patients with vestibular schwannomas underwent gamma knife radiosurgery between 1993 and 2000.
- Tumor doses ranged from 7.5 to 15.0 Gy, with a median of 12.0 Gy.
- Patient outcomes were assessed via audiometry, neurological exams, and serial imaging.
Main Results:
- Tumor control was achieved in 96% of 45 patients followed for a median of 3.6 years.
- All 33 previously untreated patients showed tumor control.
- Transient facial weakness occurred in 4% of patients and resolved; no trigeminal neuropathy was observed. Hearing preservation was high for patients with good baseline hearing.
Conclusions:
- Low-dose radiosurgery provides effective local control for vestibular schwannomas with a low complication rate.
- The current standard dose at the University of Maryland Medical Center is 12.0 Gy to the tumor periphery.
- Further follow-up is needed for definitive conclusions on long-term tumor control and hearing preservation.