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Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma.

Abstract：

OBJECTIVE:To retrospectively examine the outcomes of hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannomas. METHODS:Twenty-five patients with 26 vestibular schwannomas were treated with hypofractionated stereotactic radiation therapy using a CyberKnife. The vestibular schwannomas of 5 patients were associated with type II neurofibromatosis. The median follow-up time was 80 months (range: 6-167); the median planning target volume was 2.6 cm(3) (0.3-15.4); and the median prescribed dose (≥D90) was 21 Gy in three fractions (18-25 Gy in three to five fractions). Progression was defined as ≥2 mm 3-dimensional post-treatment tumor enlargement excluding transient expansion. Progression or any death was counted as an event in progression-free survival rates, whereas only progression was counted in progression-free rates. RESULTS:The 7-year progression-free survival and progression-free rates were 78 and 95%, respectively. Late adverse events (≥3 months) with grades based on Common Terminology Criteria for Adverse Events, v4.03 were observed in 6 patients: Grade 3 hydrocephalus in one patient, Grade 2 facial nerve disorders in two and Grade 1-2 tinnitus in three. In total, 12 out of 25 patients maintained pure tone averages ≤50 dB before hypofractionated stereotactic radiation therapy, and 6 of these 12 patients (50%) maintained pure tone averages at this level at the final audiometric follow-up after hypofractionated stereotactic radiation therapy. However, gradient deterioration of pure tone average was observed in 11 of these 12 patients. The mean pure tone averages before hypofractionated stereotactic radiation therapy and at the final follow-up for the aforementioned 12 patients were 29.8 and 57.1 dB, respectively. CONCLUSIONS:Treating vestibular schwannomas with hypofractionated stereotactic radiation therapy in three to five fractions may prevent tumor progression with tolerable toxicity. However, gradient deterioration of pure tone average was observed.

journal_name

Jpn J Clin Oncol

journal_title

Japanese journal of clinical oncology

authors

Morimoto M,Yoshioka Y,Kotsuma T,Adachi K,Shiomi H,Suzuki O,Seo Y,Koizumi M,Kagawa N,Kinoshita M,Hashimoto N,Ogawa K

doi

10.1093/jjco/hyt082

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

805-12

issue

eissn

0368-2811

issn

1465-3621

pii

hyt082

journal_volume

pub_type

杂志文章

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Hypofractionated stereotactic radiation therapy in three to five fractions for vestibular schwannoma.