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Stereotactic radiosurgery using the gamma knife for acoustic neuromas
R L Foote1, R J Coffey, J W Swanson
1Mayo Clinic, Division of Radiation Oncology, Rochester, MN 55905, USA.
Summary
Stereotactic radiosurgery with the Gamma Knife effectively controls acoustic neuromas in the short term. This treatment preserves useful hearing in many patients, though neuropathy risks exist.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Acoustic neuromas, benign tumors of the vestibulocochlear nerve, can cause hearing loss and balance issues.
- Stereotactic radiosurgery (SRS) offers a non-invasive treatment option for these tumors.
Purpose of the Study:
- To evaluate the efficacy and toxicity of Gamma Knife stereotactic radiosurgery for acoustic neuroma treatment.
- To assess tumor control rates and the incidence of treatment-related side effects.
Main Methods:
- 36 patients with acoustic neuromas underwent Gamma Knife SRS between 1990 and 1993.
- Tumor doses ranged from 16-20 Gy based on maximum diameter (6-32 mm).
- Follow-up included imaging and neurological assessments.
Main Results:
- At a median of 16 months, all tumors showed stability or shrinkage; none progressed.
- 1- and 2-year actuarial rates for facial and trigeminal neuropathy were significant (up to 81.7%).
- Useful hearing preservation was achieved in 100% at 1 year and 41.7% at 2 years.
Conclusions:
- Gamma Knife SRS provides effective short-term acoustic neuroma control with doses of 16-20 Gy.
- Preservation of useful hearing is achievable in a substantial number of patients.
- Neuropathy incidence is a significant toxicity to consider.