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Hearing preservation after gamma knife stereotactic radiosurgery of vestibular schwannoma

Cited 125 time in Web of Science Cited 120 time in Scopus
Authors
Paek, Sun Ha; Chung, Hyun-Tai; Jeong, Sang Soon; Park, Chul-Kee; Kim, Chae-Yong; Kim, Jeong Eun; Kim, Dong Gyu; Jung, Hee-Won
Issue Date
2005-06-14
Publisher
John Wiley & Sons
Citation
Cancer. 2005 Aug 1;104(3):580-90.
Keywords
AdultAgedCochlear Nerve/*pathologyFemaleFollow-Up StudiesHearing Loss/diagnosis/etiology/*prevention & controlHumansMaleMiddle AgedNeuroma, Acoustic/pathology/*surgeryPostoperative Complications/diagnosis/etiology/*prevention & controlProspective Studies*RadiosurgeryStereotaxic TechniquesTreatment OutcomeTumor Burden
Abstract
BACKGROUND: To evaluate the hearing preservation rate and to determine its prognostic factors after gamma knife (GK) stereotactic radiosurgery (SRS) in patients with vestibular schwannoma, the authors used a prospective study design to analyze these patients. METHODS: Between December 1997 and January 2002, 25 patients with vestibular schwannoma with serviceable hearing were enrolled in the current study. The median tumor volume was 3.0 cc (0.16-9.1 cc). The prescription dose was 12.0 +/- 0.7 gray at an isodose line of 49.8 +/- 1.1%. The tumor control rate and complications were evaluated by focusing on hearing preservation and its prognostic factors. RESULTS: Based on radiologic study, the tumor control rate was 92% during the median follow-up period of 45 months. The trigeminal and facial nerve preservation rates were 95% and 100%, respectively. Thirteen (52%) of the 25 patients preserved serviceable hearing and 9 (36%) patients retained their pre-GK G-R grade levels after GK SRS. However, 16 patients showed hearing deterioration > 20 dB within 3-6 months and this trend continued for 24 months after the treatment. The maximum radiotherapy dose delivered to the cochlear nucleus was the single, significant prognostic factor of hearing deterioration. CONCLUSIONS: The authors concluded that a more sophisticated strategy to prevent hearing deterioration during the first 6 months post-GK SRS is necessary to improve long-term hearing preservation.
ISSN
0008-543X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15952200

http://hdl.handle.net/10371/15569
DOI
https://doi.org/10.1002/cncr.21190
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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