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Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy
PURPOSE: Our purpose was to study the outcomes of hypofractionated stereotactic radiation therapy (HSRT) in terms of hearing and radiologic response for vestibular schwannomas. METHODS AND MATERIALS: This was a longitudinal retrospective study at a referral center from 2011 to 2016. All treatments w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361054/ https://www.ncbi.nlm.nih.gov/pubmed/34409203 http://dx.doi.org/10.1016/j.adro.2021.100694 |
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author | Pialat, Pierre-Marie Fieux, Maxime Tringali, Stéphane Beldjoudi, Guillaume Pommier, Pascal Tanguy, Ronan |
author_facet | Pialat, Pierre-Marie Fieux, Maxime Tringali, Stéphane Beldjoudi, Guillaume Pommier, Pascal Tanguy, Ronan |
author_sort | Pialat, Pierre-Marie |
collection | PubMed |
description | PURPOSE: Our purpose was to study the outcomes of hypofractionated stereotactic radiation therapy (HSRT) in terms of hearing and radiologic response for vestibular schwannomas. METHODS AND MATERIALS: This was a longitudinal retrospective study at a referral center from 2011 to 2016. All treatments were performed on a Cyberknife device with a dose of 21 Gy (3 × 7 Gy) or 25 Gy (5 × 5 Gy). We assessed tumor response, neurologic outcomes (hearing and facial nerve function), and treatment toxicity. RESULTS: A total of 82 patients were included. Fifty-three patients were treated with the 3 × 7 Gy scheme and 29 with the 5 × 5 Gy. Sixteen patients (20%) had a previous surgery. The median follow-up was 48 months (range, 12-88 months). We noted 3 recurrences leading to a control rate of 96.3%. In our cohort, predictive factors of vestibular schwannoma growth were a tumor volume >2 mm(3) and a conformal index <1.1 (P < .0001). The treatment was well tolerated with only 5 grade III acute toxicities (4 vertigo and 1 headache) and no grade IV or V. As for late toxicity, we noticed 2 cases of mild peripheral facial palsy (House and Brackman grade II) in previously operated patients. There was 46.0% hearing preservation among patients with serviceable hearing after HSRT. CONCLUSIONS: Our results suggest that HSRT using 3 or 5 fractions is a well-tolerated and effective regimen. These findings are in addition to the few previous hypofractionation studies and contribute to the validity of this treatment modality. |
format | Online Article Text |
id | pubmed-8361054 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-83610542021-08-17 Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy Pialat, Pierre-Marie Fieux, Maxime Tringali, Stéphane Beldjoudi, Guillaume Pommier, Pascal Tanguy, Ronan Adv Radiat Oncol Scientific Article PURPOSE: Our purpose was to study the outcomes of hypofractionated stereotactic radiation therapy (HSRT) in terms of hearing and radiologic response for vestibular schwannomas. METHODS AND MATERIALS: This was a longitudinal retrospective study at a referral center from 2011 to 2016. All treatments were performed on a Cyberknife device with a dose of 21 Gy (3 × 7 Gy) or 25 Gy (5 × 5 Gy). We assessed tumor response, neurologic outcomes (hearing and facial nerve function), and treatment toxicity. RESULTS: A total of 82 patients were included. Fifty-three patients were treated with the 3 × 7 Gy scheme and 29 with the 5 × 5 Gy. Sixteen patients (20%) had a previous surgery. The median follow-up was 48 months (range, 12-88 months). We noted 3 recurrences leading to a control rate of 96.3%. In our cohort, predictive factors of vestibular schwannoma growth were a tumor volume >2 mm(3) and a conformal index <1.1 (P < .0001). The treatment was well tolerated with only 5 grade III acute toxicities (4 vertigo and 1 headache) and no grade IV or V. As for late toxicity, we noticed 2 cases of mild peripheral facial palsy (House and Brackman grade II) in previously operated patients. There was 46.0% hearing preservation among patients with serviceable hearing after HSRT. CONCLUSIONS: Our results suggest that HSRT using 3 or 5 fractions is a well-tolerated and effective regimen. These findings are in addition to the few previous hypofractionation studies and contribute to the validity of this treatment modality. Elsevier 2021-03-23 /pmc/articles/PMC8361054/ /pubmed/34409203 http://dx.doi.org/10.1016/j.adro.2021.100694 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Scientific Article Pialat, Pierre-Marie Fieux, Maxime Tringali, Stéphane Beldjoudi, Guillaume Pommier, Pascal Tanguy, Ronan Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title | Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title_full | Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title_fullStr | Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title_full_unstemmed | Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title_short | Vestibular Schwannoma: Results of Hypofractionated Stereotactic Radiation Therapy |
title_sort | vestibular schwannoma: results of hypofractionated stereotactic radiation therapy |
topic | Scientific Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361054/ https://www.ncbi.nlm.nih.gov/pubmed/34409203 http://dx.doi.org/10.1016/j.adro.2021.100694 |
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