Outcomes for Patients With Vestibular Schwannomas Treated With Gamma Knife Versus Linear Accelerator-Based...

Prior studies have reported favorable local control for patients with vestibular schwannomas (VS) treated with Gamma Knife radiosurgery (GKRS) or linear accelerator (LINAC)-based radiosurgery; however, direct comparisons of quality-of-life outcomes with each approach are lacking. We assessed differences in quality-of-life outcomes and local control after radiation therapy for patients with VS treated with GKRS versus LINAC.

In this multicenter analysis, we retrospectively reviewed VS cases treated with either GKRS or LINAC and compared posttreatment clinical outcomes, including tumor control and new development of vertigo, gait disturbance, facial palsy, and tinnitus. Descriptive statistics were performed, and χ2 was used to assess intergroup differences. Univariate and multivariate analyses were performed to assess associations with the development of clinical outcomes.

Thirty-six patients treated with GKRS and 49 patients treated with LINAC were included in our analysis. All patients were treated with single-fraction radiosurgery. There was no statistically significant difference between LINAC and GKRS in the development of vertigo, gait disturbance, or facial palsy after treatment, and no clinically significant difference in the development of tinnitus. Local control was 98.8% across all patients, with no statistically significant difference in tumor control between groups.

This analysis showed comparable rates of new vertigo, gait disturbance, tinnitus, and facial palsy with GKRS and LINAC-based radiosurgery for VS, supporting the interchangeability of these treatment approaches. Prospective data are needed to further compare these treatment approaches.