ORBi: Rutten Isabelle - Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma

Reference : Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Surgery Human health sciences : Radiology, nuclear medicine & imaging Human health sciences : Oncology
	To cite this reference:	http://hdl.handle.net/2268/39967

Title :	Long-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma
Language :	English
Author, co-author :	Rutten, Isabelle [> > > >]
	Baumert, B. G. [> > > >]
	Seidel, Laurence [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique >]
	Kotolenko, S. [> > > >]
	Collignon, Jacques [Centre Hospitalier Universitaire de Liège - CHU > > Imagerie médicale >]
	Kaschten, Bruno [Centre Hospitalier Universitaire de Liège - CHU > > Neurochirurgie >]
	Albert, Adelin [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique >]
	Martin, Didier [Université de Liège - ULg > Département des sciences cliniques > Neurochirurgie]
	Deneufbourg, Jean-Marie [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
	Demanez, Jean-Pierre [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
	Stevenaert, Achille [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
Publication date :	Jan-2007
Journal title :	Radiotherapy & Oncology
Publisher :	Elsevier Ireland Ltd
Volume :	82
Issue/season :	1
Pages :	83-89
Audience :	International
ISSN :	0167-8140
City :	Clare
Keywords :	[en] radiosurgery ; vestibular schwannomas ; cranial nerve toxicity
Abstract :	[en] AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age: 67, range: 30-82) with a vestibular schwannoma were treated by Linac-based stereotactic radiosurgery (SRS). The median follow-up was 49 months (16-85 months). Only progressive tumours were treated. The median size of tumours was 18 mm (range 9-30 mm). Before SRS, 11 patients had a useful hearing (Gardner-Robertson classes 1 and 2). Single doses of 10-14 Gy were prescribed at the 80% isodose at the tumour margin. The follow-up consisted of regular imaging with MRI the first 3-6 months after the intervention, followed by additional yearly MRIs, a hearing test and a neurological examination. RESULT: The 5-year-probability of tumour control (defined as stabilization or decrease in size) was 95%. Five-year-probability of preservation of hearing and facial nerve function was 96% and 100%, respectively. Hearing was preserved in 10 out of 11 patients who had a normal or useful hearing at the time of treatment. Mild and transient trigeminal toxicity occurred in 2 (8%) patients. It appeared to be significantly correlated to the dose used (p=0.044). However, only a tendency to significance could be demonstrated in the relationship between the two factors when using the Cox analysis (hazard ratio=1.7; 95% CI: 0.7-3.9; p=0.23). CONCLUSIONS: With the doses used, our study demonstrates that SRS provides an equivalent tumour control rate when compared to surgery, as well as on a long-term basis, an excellent preservation of the facial and the acoustic nerves. Although no permanent trigeminal toxicity was observed, our data confirm that doses below 14 Gy can avoid transient dysesthesias.
Permalink :	http://hdl.handle.net/2268/39967
DOI :	10.1016/j.radonc.2006.11.019

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