Fractionated stereotactic radiotherapy (FSR) is a recognized treatment for vestibular schwannomas (VS). This study's aim is to present clinical outcomes and local control (LC) results for patients with VS treated with FSR using the Cyberknife® (CK) in 2 French cancer centers.
Methods
Patients treated with FSR for VS between 2007 and 2012 were retrospectively analyzed. Local control was determined using follow-up MRI. The hearing preservation (HP) rate was determined by analyzing pretreatment and posttreatment audiograms.
Results
Forty patients were treated for VS with the CK in both centers. The mean maximal VS dimension was 18.3 mm (range 3–30). The median follow-up was 36 months and the LC was 97% at 3 years of follow-up and 89% after 5 years. The HP rate was 83% and no facial nerve impairment was reported.
Conclusions
Our results in terms of LC and HP rate are congruent with similar studies that use the CK to treat VS. It appears that the CK is safe and efficient in VS management even for large lesions. Further studies with larger cohorts are warranted.
CastagnoLA.Acoustic neuroma: anatomo-clinical correlations in the posterior wall of the temporal bone.Rev Laryngol Otol Rhinol (Bord).1990;111(3):207–210.
2.
KatayamaS, TsuboiM, SuzukiK, KunitomoT.[A case of facial nerve neurinoma originated from the cerebellopontine angle portion].No Shinkei Geka.1989;17(11):1041–1046.
LassalettaL, GavilénJ.[An update on the treatment of vestibular schwannoma].Acta Otorrinolaringol Esp.2009;60(2):131–140.
7.
QuesnelAM, McKennaMJ.Current strategies in management of intracanalicular vestibular schwannoma.Curr Opin Otolaryngol Head Neck Surg.2011;19(5):335–340.
8.
ArthursBJ, FairbanksRK, DemakasJJ, LamoreauxWT, GiddingsNA, MackayAR, A review of treatment modalities for vestibular schwannoma.Neurosurg Rev.2011 Jul;34(3):265–277–279.
9.
ArriagaMA, LinJ.Translabyrinthine approach: indications, techniques, and results.Otolaryngol Clin North Am.2012;45(2):399–415, ix.
10.
ElhammadyMS, TelischiFF, MorcosJJ.Retrosigmoid approach: indications, techniques, and results.Otolaryngol Clin North Am.2012;45(2):375–397, ix.
11.
AngeliS.Middle fossa approach: indications, technique, and results.Otolaryngol Clin North Am.2012;45(2):417–438, ix.
12.
AnsariSF, TerryC, Cohen-GadolAA.Surgery for vestibular schwannomas: a systematic review of complications by approach.Neurosurg Focus.2012;33(3):E14.
13.
BetkaJ, ZvěřinaE, BalogováZ, Complications of Microsurgery of Vestibular Schwannoma.BioMed Res Int.2014 May; 2014:e315952.
14.
LeksellL.The stereotaxic method and radiosurgery of the brain.Acta Chir Scand.1951;102(4):316–319.
15.
NoëlG, BauerN, ClavierJ-B, GuihardS, LimO, JastaniahZ.Radiothérapie en conditions stéréotaxiques des tumeurs bénignes intracrâniennes.Cancer Radiothérapie J Société Fr Radiothérapie Oncol.2012;16(5–6):410–417.
16.
ChungW-Y, LiuK-D, ShiauC-Y, Gamma knife surgery for vestibular schwannoma: 10-year experience of 195 cases.J Neurosurg.2013;119(Suppl):87–97.
17.
LunsfordLD, NiranjanA, FlickingerJC, MaitzA, KondziolkaD.Radiosurgery of vestibular schwannomas: summary of experience in 829 cases.J Neurosurg.2013;119(Suppl):195–199.
18.
HempelJM, HempelE, WowraB, SchichorCh, MuacevicA, RiedererA.Functional outcome after gamma knife treatment in vestibular schwannoma.Eur Arch Otorhinolaryngol.2006;263(8):714–718.
19.
HasegawaT, FujitaniS, KatsumataS, KidaY, YoshimotoM, KoikeJ.Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years.Neurosurgery.2005Aug;57(2):257–265–265.
20.
ChopraR, KondziolkaD, NiranjanA, LunsfordLD, FlickingerJC.Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy.Int J Radiat Oncol Biol Phys.2007;68(3):845–851.
21.
CollenC, AmpeB, GevaertT, Single fraction versus fractionated linac-based stereotactic radiotherapy for vestibular schwannoma: a single-institution experience.Int J Radiat Oncol Biol Phys.2011;81(4):e503–e509.
22.
TimmermanRD.An overview of hypofractionation and introduction to this issue of seminars in radiation oncology.Semin Radiat Oncol.2008;18(4):215–222.
23.
RashidA, KaramSD, RashidB, Multisession Radiosurgery for Hearing Preservation.Semin Radiat Oncol.2016;26(2):105–111.
24.
SarfarazM.CyberKnife robotic arm stereotactic radiosurgery.J Am Coll Radiol.2007;4(8):563–565.
25.
KoosW.Microsurgery of cerebellopontine angle tumors.Clinical Microneurosurgery.1976;91–112.
26.
KanzakiJ, TosM, SannaM, MoffatDA, MonsellEM, BerlinerKI.New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma.Otol Neurotol.2003;24(4):642–648, discussion 648–649.
HouseJW, BrackmannDE.Facial nerve grading system.Otolaryngol Head Neck Surg.1985;93(2):146–147.
29.
MolenberghsG, VerbekeG.Linear Mixed Models for Longitudinal Data [Internet].New York, NY: Springer New York; 2000 [cited 2015 Aug 11]. (Springer Series in Statistics). Available from: http://link.springer.com/10.1007/978-1-4419-0300-6.
30.
RégisJ, CarronR, MoucharrafienS, [Role of radiosurgery and stereotactic radiotherapy in the management of vestibular schwannomas].Cancer Radiother.2012;16(Suppl):S70–S78.
31.
TsaiJ-T, LinJ-W, LinC-M, Clinical Evaluation of CyberKnife in the Treatment of Vestibular Schwannomas.BioMed Res Int.2013 Nov 10; 2013:e297093.
32.
KaramSD, TaiA, StrohlA, Frameless fractionated stereotactic radiosurgery for vestibular schwannomas: a single-institution experience.Front Oncol.2013;3:121.
33.
IshiharaH, SaitoK, NishizakiT, CyberKnife radiosurgery for vestibular schwannoma.Minim Invasive Neurosurg.2004;47(5):290–293.
34.
CasentiniL, FornezzaU, PeriniZ, PerissinottoE, ColomboF.Multisession stereotactic radiosurgery for large vestibular schwannomas.J Neurosurg.2015;122(4):818–824.
35.
HansasutaA, ChoiCYH, GibbsIC, Multisession stereotactic radiosurgery for vestibular schwannomas: single-institution experience with 383 cases.Neurosurgery.2011;69(6):1200–1209.
36.
MorimotoM, YoshiokaY, KotsumaT, Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma.Jpn J Clin Oncol.2013;43(8):805–812.
37.
BoariN, BailoM, GagliardiF, Gamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients.J Neurosurg.2014;121(Suppl):123–142.
38.
HathoutL.Transient Tumor Volume Increase in Vestibular Schwannomas After Radiotherapy.Cureus [Internet].2012 Nov 26 [cited 2015 Jul 27]; Available from: http://www.cureus.com/papers/170.
39.
YangI, SughrueME, HanSJ, A comprehensive analysis of hearing preservation after radiosurgery for vestibular schwannoma.J Neurosurg.2010;112(4):851–859.
40.
CombsSE, EngelhardC, KoppC, Long-term outcome after highly advanced single-dose or fractionated radiotherapy in patients with vestibular schwannomas - pooled results from 3 large German centers.Radiother Oncol.2015;114(3):378–383.
41.
KohE-S, MillarB-A, MénardC, Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital.Cancer.2007;109(6):1203–1210.
42.
AndrewsDW, Werner-WasikM, DenRB, Toward dose optimization for fractionated stereotactic radiotherapy for acoustic neuromas: comparison of two dose cohorts.Int J Radiat Oncol Biol Phys.2009;74(2):419–426.
