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Radiosurgical Treatment of Vestibular Schwannomas in Patients with Neurofibromatosis Type 2

Cited 59 time in Web of Science Cited 65 time in Scopus
Issue Date
2009-01-15
Publisher
JOHN WILEY & SONS INC
Citation
CANCER; Vol.115 2; 390-398
Keywords
vestibular schwannomahearing preservationneurofibromatosis type 2gamma knife radiosurgery
Abstract
BACKGROUND: The radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2 (NF2) is controversial. The authors investigated the radiologically proven tumor control rate after gamma knife radiosurgery. The factors that affect tumor control and serviceable hearing preservation were analyzed. METHODS: Thirty-six lesions in 30 patients were included. The median lengths of the clinical and radiologic follow-ups were 48.5 months and 36.5 months, respectively. The median tumor volume was 3.2 cm(3). The mean marginal dose was 12.1 grays (Gy) (range, 8-14 Gy) at an isodose line of 50%+/- 0.6%. The Kaplan-Meier method and Cox proportional hazards model were used for the statistical analyses. RESULTS: The actuarial tumor control rate was 81%, 74%, and 66%, respectively, in the first, second, and fifth years. Five tumors required a salvage surgery because of tumor control failure. A low marginal dose and a young age at radiosurgery were associated with poor tumor control. Of the 16 tumors with which ipsilateral hearing was 4 serviceable, the actuarial serviceable hearing preservation rates were 50%, 45%, and 33%, respectively, in the first, second, and fifth years. Better ipsilateral hearing (Gardner-Robertson grade 1, compared with grade 2) at the time of radiosurgery was associated with significantly greater serviceable hearing preservation. CONCLUSIONS: Gamma knife radiosurgery for vestibular schwannomas in NF2 patients provided 5-year tumor A control in approximately two-thirds of patients and preserved serviceable hearing in approximately one-third. The rates of other cranial nerve deficits were low, and no secondary malignancy was observed. Radiosurgery should be included in treatment options for NF2 patients. Cancer 2009;115:390-8. (C) 2009 American Cancer Society.
ISSN
0008-543X
Language
English
URI
https://hdl.handle.net/10371/76920
DOI
https://doi.org/10.1002/cncr.24036
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College of Medicine/School of Medicine (의과대학/대학원)Preventive Medicine (예방의학전공)Journal Papers (저널논문_예방의학전공)
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