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Stereotactic Radiosurgery for Gynecologic Cancer
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Repeat Stereotactic Radiosurgery for Progressive or Recurrent Vestibular Schwannomas
Christian Iorio-Morin1, Roman Liscak2, Vilibald Vladyka2
1Division of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Québec, Canada.
Neurosurgery
|September 7, 2018
Summary
Repeat stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) offers high tumor control rates. This approach is safe and effective for managing VS progression after initial SRS treatment.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Stereotactic radiosurgery (SRS) is a primary treatment for vestibular schwannomas (VS), achieving high long-term control rates.
- Limited data exist on managing VS progression after initial SRS.
Purpose of the Study:
- To evaluate the safety and efficacy of a second SRS procedure for patients with VS that progressed after initial SRS.
- To assess tumor control and clinical outcomes following repeat SRS for VS.
Main Methods:
- Retrospective analysis of 76 patients from 8 International Gamma Knife Research Foundation (IGKRF) centers.
- Data included patient and radiosurgery details, clinical symptoms, imaging, and follow-up outcomes.
- Actuarial analyses were used to determine tumor control rates and clinical evolution.
Main Results:
- Repeat SRS demonstrated high actuarial tumor control rates: 98.6% at 2 years, 92.2% at 5 years, and 92.2% at 10 years.
- Useful hearing preservation decreased over time, but 75% of patients reported stable or improved symptoms post-repeat SRS.
- No cases of radionecrosis, radiation-associated edema, radiation-related neoplasia, or death were attributed to the repeat SRS procedure.
Conclusions:
- A second SRS procedure is a safe and effective management option for patients with progressing vestibular schwannomas after initial radiosurgery.
- Repeat SRS can achieve durable tumor control with acceptable toxicity profiles.
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