OBJECTIVE: The results of radiosurgical treatment of acoustic neuromas have improved by reducing the tumor marginal doses. We report relatively long-term follow-up results (>5 yr) for patients who underwent low-dose radiosurgery. METHODS: We treated and followed 51 consecutive patients with unilateral acoustic neuromas who were treated from January 1994 to December 1996 by gamma knife radiosurgery at low doses (</=12 Gy to the tumor margin). The average age of the patients was 55 years (range, 32-76 yr). The treatment volume was 0.7 to 24.9 cm(3) (median, 3.6 cm(3)). The marginal radiation dose was 8 to 12 Gy (median, 12 Gy), and the follow-up period ranged from 18 to 96 months (median, 60 mo). RESULTS: Clinical tumor growth control (without tumor resection) was achieved in 96% of patients, and the 5-year tumor growth control rate was 92%. Hearing was preserved in 59% of those with preradiosurgical hearing preservation (Gardner-Robertson Classes 1-4), and improvements (>20 dB of improvement) were noted in 9% of the patients with any hearing. Hearing was preserved at a useful level (Gardner-Robertson Classes 1 and 2) in 56% of patients. Although preexisting trigeminal neuropathy worsened in 4% of the patients, our patients did not experience new facial palsies or trigeminal neuropathies after radiosurgery. Facial spasm occurred in 6% of the patients, and intratumoral bleeding occurred in 4% of patients. CONCLUSION: Low-dose radiosurgery (</=12 Gy at the tumor margin) can achieve a high tumor growth control rate and maintain low postradiosurgical morbidity (including hearing preservation) for acoustic neuromas.
OBJECTIVE: The results of radiosurgical treatment of acoustic neuromas have improved by reducing the tumor marginal doses. We report relatively long-term follow-up results (>5 yr) for patients who underwent low-dose radiosurgery. METHODS: We treated and followed 51 consecutive patients with unilateral acoustic neuromas who were treated from January 1994 to December 1996 by gamma knife radiosurgery at low doses (</=12 Gy to the tumor margin). The average age of the patients was 55 years (range, 32-76 yr). The treatment volume was 0.7 to 24.9 cm(3) (median, 3.6 cm(3)). The marginal radiation dose was 8 to 12 Gy (median, 12 Gy), and the follow-up period ranged from 18 to 96 months (median, 60 mo). RESULTS: Clinical tumor growth control (without tumor resection) was achieved in 96% of patients, and the 5-year tumor growth control rate was 92%. Hearing was preserved in 59% of those with preradiosurgical hearing preservation (Gardner-Robertson Classes 1-4), and improvements (>20 dB of improvement) were noted in 9% of the patients with any hearing. Hearing was preserved at a useful level (Gardner-Robertson Classes 1 and 2) in 56% of patients. Although preexisting trigeminal neuropathy worsened in 4% of the patients, our patients did not experience new facial palsies or trigeminal neuropathies after radiosurgery. Facial spasm occurred in 6% of the patients, and intratumoral bleeding occurred in 4% of patients. CONCLUSION: Low-dose radiosurgery (</=12 Gy at the tumor margin) can achieve a high tumor growth control rate and maintain low postradiosurgical morbidity (including hearing preservation) for acoustic neuromas.
Authors: Erika Ann Woodson; Ryan Douglas Dempewolf; Samuel Paul Gubbels; Aaron Thomas Porter; Jacob Jay Oleson; Marlan Rex Hansen; Bruce Jay Gantz Journal: Otol Neurotol Date: 2010-09 Impact factor: 2.311
Authors: Andrew J Schumacher; Rohan R Lall; Rishi R Lall; Allan Nanney; Amit Ayer; Samir Sejpal; Benjamin P Liu; Maryanne Marymont; Plato Lee; Bernard R Bendok; John A Kalapurakal; James P Chandler Journal: J Neurol Surg B Skull Base Date: 2016-05-31
Authors: Yoichi Nonaka; Takanori Fukushima; Kentaro Watanabe; Allan H Friedman; Calhoun D Cunningham; Ali R Zomorodi Journal: Neurosurg Rev Date: 2016-01-19 Impact factor: 3.042
Authors: Susan C Pannullo; Justin F Fraser; Jennifer Moliterno; William Cobb; Philip E Stieg Journal: J Neurooncol Date: 2010-12-09 Impact factor: 4.130