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Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Stereotactic radiotherapy for trigeminal schwannomas
Colin E Champ1, Mark V Mishra, Wenyin Shi
1Department of Radiation Oncology, Kimmel Cancer Center and Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. colin.champ@jeffersonhospital.org
Neurosurgery
|April 5, 2012
Summary
Radiotherapy, including stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT), offers excellent tumor control for trigeminal schwannomas (TSs). A rare flare phenomenon was observed with FSRT.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Limited data exists on radiotherapy for trigeminal schwannomas (TSs).
- Comparison between stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) for TSs is scarce.
Purpose of the Study:
- To review institutional experience with SRS and FSRT for TSs.
- To describe a rare flare phenomenon observed in some patients.
Main Methods:
- Retrospective review of 23 consecutive TSs patients treated between 1996 and 2011.
- Analysis of radiographic response, tumor control, and toxicity.
- Comparison of outcomes between SRS and FSRT groups.
Main Results:
- Overall tumor control at 5 and 10 years was 94%.
- Symptom control at 5 years was 48%, with a trend towards better outcomes with FSRT (56% vs 40%).
- Higher acute toxicity (38.5% vs 0%) and larger lesion size (9.5 mL vs 4.8 mL) were noted in the FSRT group. A flare phenomenon occurred in 8.7% of patients during FSRT.
Conclusions:
- Both SRS and FSRT provide excellent tumor control for TSs with minimal toxicity.
- This study documents the first reported flare phenomenon after FSRT for TS.
- Discussing flare risk and considering prophylactic steroids for FSRT in large, previously resected lesions is recommended.
