Abstract
CyberKnife stereotactic radiosurgery (CKSRS) has been proved effective in treating intra-cranial lesions. To treat acoustic neuroma (AN) patients with or without neurofibromatosis Type 2 (NF2) associations, the functional preservation of hearing, trigeminal nerve, and facial nerve are important.
Twenty-one patients were treated with hypofractionated CKSRS. Fourteen non-NF2 and seven NF2 patients were enrolled. Cranial nerve function, audiograms, and magnetic resonance images (MRI) were monitored.
Mean follow-up was 15 month. Tumors with volumes ranging from 0.13 to 24.8 cm3 (mean 5.4 cm3) were irradiated with the marginal dose 1800-2000 cGy/3 fractions. Tumors were treated with an 80 to 89% isodose line (mean 83%) and mean 97.9% tumor coverage. Two patients experienced hearing deterioration (16.7%) in the non-NF2 group, and 3 patients (50%) in the NF2 group. No facial or trigeminal dysfunction, brain stem toxicity, or cerebellar edema occurred. Tumor regression was seen in 9 patients (43%) and stable in 12 patients (57%). 100% tumor control rate was achieved.
Hypofractionated CKSRS was not only effective in tumor control but also excellent in hearing preservation for non-NF2 AN. But for NF2 patients, although the tumor control was remarkable, hearing preservation was modest as in non-NF2 patients.
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References
Chang SD, Gibbs IC, Sakamoto GT, et al (2005) Staged stereotactic irradiation for acoustic neuroma. Neurosurgery 56: 1254–1261
Chang SD, Murphy M, Geis P, et al (1998) Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors. Neurol Med Chir (Tokyo) 38: 780–783
Curati WL, Graif M, Kingsley DP, et al (1986) Acoustic neuromas Gd-DTPA enhancement in MR imaging. Radiology 158: 447–451
Degen JW, Gagnon GJ, Voyadzis JM, et al (2005) CyberKnife stereotactic radiosurgical treatment of spinal tumors for pain control and quality of life. J Neurosurg Spine 2: 540–549
Dhanachai M, Theerapancharoen V, Laothamatas J, et al (2004) Fractionated stereotactic radiotherapy for bilateral vestibular schwannomas associated with neuronfibromatosis type 2: early experiences in Ramathibodi Hospital. J Med Assoc Thai 87: 1076–1081
Fischer G, Fischer C, Remond J (1992) Hearing preservation in acoustic neurinoma surgery. J Neurosurg 76: 910–917
Flickinger JC, Lunsford LD, Linskey ME, et al (1993) Gamma knife radiosurgery for acoustic tumors: multivariate analysis of four year results. Radiother Oncol 27: 91–98
Gardner G, Robertson JH (1988) Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 97: 55–66
Gormley WB, Sekhar LN, Wright DC, et al (1997) Acoustic neuromas: results of current surgical management. Neurosurgery 41: 50–58
Harada K, Nishizaki T, Adachi N, et al (2000) Pédiatric acoustic schwannoma showing rapid regrowth with high proliferative activity. Childs Nerv Syst 16: 134–137
Kang SH, Cho HT, Devi S, et al (2006) Antitumor effect of 2-methoxyestradiol in a rat orthotopic brain tumor model. Cancer Res 66: 11991–11997
Kondziolka D, Lunsford LD, McLaughlin MR, et al (1998) Long-term outcomes after radiosurgery for acoustic neuromas. N Engl J Med 339: 1426–1433
Lunsford LD, Linskey ME (1992) Stereotactic radiosurgery in the treatment of patients with acoustic tumors. Otolaryngol Clin North Am 25: 471–491
Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve-preservation and restitution of function. Neurosurgery 40: 684–694
Spiegelmann R, Gofman J, Alezra D, et al (1999) Radiosurgery for acoustic neurinomas (vestibular schwannomas). Isr Med Assoc J 1: 8–13
Subach BR, Kondziolka D, Lunsford LD, et al (1999) Stereotactic radiosurgery in the management of acoustic neuromas associated with neurofibromatosis Type 2. J Neurosurg 90: 815–822
Suh JH, Barnett GH, Sohn JW, et al (2000) Results of linear accelerator-based stereotactic radiosurgery for recurrent and newly diagnosed acoustic neuromas. Int J Cancer 90: 145–151
Williams JA (2002) Fractionated stereotactic radiotherapy for acoustic neuromas. Acta Neurochir (Wien) 144: 1249–1254
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Ju, D.T. et al. (2008). Hypofractionated CyberKnife stereotactic radiosurgery for acoustic neuromas with and without association to neurofibromatosis Type 2. In: Chiu, WT., et al. Reconstructive Neurosurgery. Acta Neurochirurgica Supplementum, vol 101. Springer, Vienna. https://doi.org/10.1007/978-3-211-78205-7_29
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DOI: https://doi.org/10.1007/978-3-211-78205-7_29
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