Introduction
Methods
Subjects and populations
Indication for SRS
Tumor control
Radiosurgery with modified linear accelerator (LINAC)
Radiosurgery with cyberknife®
Imaging techniques for SRS
Statistical analysis
Results
Patient collective
Patient characteristics | |
Total no. of patients | 49 |
Gender (m:f) | 28 : 21 |
Recurrent iAN | 4 (8.2%) |
Age (years)a
| 54 (20;77) |
Tumor volume (cm3)a
| 0.24 (0.1;0.68) |
Mean follow-up (months)a
| 65 (4;239) |
Initial Symptoms and Signs | |
Hearing loss | 6 (12.2%) |
Hearing disturbance (%) | 40 (81.6%) |
- Serviceable | 29 (59.2%) |
- Non-serviceable | 11 (22.4%) |
Vertigo (%) | 17 (34.7%) |
Imbalance (%) | 10 (20.4%) |
Tinnitus (%) | 22 (44.9%) |
CN VII impairment (%) | 4 (8.2%) |
Duration of symptoms | |
Appearance of symptoms leading to SRS months)a
| 42.3 (4;182) |
First MRI (diagnosis) to SRS (months)a
| 19.9 (2;153) |
- Group Aa
| 34 (9;134) |
- Group Ba
| 4 (2;6) |
Radiation parameters | |
LINAC (1993–2012) | 38 |
CK (2013–2015) | 11 |
Marginal dose (Gy)a
| 12.6 (11;14) |
Dose prescription, isodose (%)a
| 75 (47;86) |
Coverage (%) LINACa
| 97.8 (91.1;100) |
Coverage (%) CKa
| 98.7 (94.8;100) |
Tumor control
Preservation of subjective hearing
Pre-, post-treatment symptoms and adverse events
Discussion
Surgery
Authors, centre & year | n | Design | SRS System | FU (months) | Tumor control (no need for further treatment) | Preservation of hearing | CTCAE rating | Permanent CN VII impairment (%) |
---|---|---|---|---|---|---|---|---|
Pittsburgh, Ogunrinde et al. 1995 [22] | 10 | R, SC | GK |
mean: 25 (3:64) | 100% | 80% (after one year) | no | 0% |
Pittsburgh, Niranjan et al. 1999 [23] | 29 | R, SC | GK |
median: 33 (9;106) | 100% | 73% | no | 0% |
Pittsburgh, Niranjan et al. 2008 [10] | 96 | R, SC | GK |
mean: 42 (12;144)
median: 28 | 99% | 64.5% | no | 2% |
Marseille, Regis et al. 2011 [11] | 34 | P, SC | GK |
mean: 44 (9;222) | 97% | 64% (after 5 years) | no | n/a |
Seoul, Kim et al. 2012 [9] | 58 | R, SC | GK |
mean: 62 (24;111) | 100% | 55% (after 5 years) | no | n/a |
Cologne, this series, 2016 | 49 | R, SC | LINAC CK |
mean: 65 (4;239)
median: 47 | 100% | 75% (after 5 years) | yes | 2% |