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Long-term outcomes of patients with primary or residual vestibular schwannoma treated with LINAC-based stereotactic radiosurgery: a single-centre experience

Published online by Cambridge University Press:  07 August 2020

Patricia Sebastian Open the ORCID record for Patricia Sebastian [Opens in a new window] ,
Subhashini John ,
Jebakarunya Reddy ,
Sunitha Susan Varghese ,
Harshad Arvind Vanjare ,
Ranjith K. Moorthy ,
Krishna Prabhu  and
Bijesh Yadav
Patricia Sebastian*
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, India
Subhashini John
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, India
Jebakarunya Reddy
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, India
Sunitha Susan Varghese
Affiliation:
Department of Radiation Oncology, Christian Medical College, Vellore, India
Harshad Arvind Vanjare
Affiliation:
Department of Radiology, Christian Medical College, Vellore, India
Ranjith K. Moorthy
Affiliation:
Department of Neurosciences and Neurosurgery, Christian Medical College, Vellore, India
Krishna Prabhu
Affiliation:
Department of Neurosciences and Neurosurgery, Christian Medical College, Vellore, India
Bijesh Yadav
Affiliation:
Department of Biostatistics, Christian Medical College, Vellore, India
*
Author for correspondence: Patricia Sebastian, Associate Professor, Department of Radiation Oncology, Christian Medical College, Vellore632004, India. Tel: +919443097564. E-mail: [email protected]
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Abstract

Aim:

Vestibular schwannomas (VS) are benign slow-growing tumours treated either with microsurgery or stereotactic radiosurgery (SRS) or both. The aim of this study was to correlate the outcome factors—tumour control and adverse factors—facial nerve function and hearing loss with patient and treatment factors.

Materials and methods:

A retrospective review of the records of 98 patients with 99 VS treated from June 2007 to June 2014, all patients receiving Linear Accelerator (LINAC)-based SRS.

Results:

Median follow-up period was 5·6 years (range: 1–12 years). The response to treatment was stable disease in 37 (37·4%), regression in 46 (46·5%), asymptomatic minimal progression in 9 (9·1%) and symptomatic progression in 5 (5%) and unknown in 2 (2%) patients. There was no evidence of SRS induced tissue damage on magnetic resonance scans for any. Hearing preservation rate after SRS was 92%. The patients who developed worsening of facial function were predominantly in the cohort that had prior surgery.

Findings:

SRS is an effective modality to treat VS lesser than 3 cm in size. Tumour control rate was 95% with a median follow-up period of 5·6 years. The complication rates were 8% each for facial function worsening and worsening of hearing. Prior surgery was a statistically significant factor that affected facial nerve function deterioration.

Keywords

Vestibular schwannomastereotactic radiosurgeryLINAC based
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 4 , December 2021 , pp. 426 - 432
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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