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Wagner J, Welzel T, Habermehl D, Debus J, Combs SE. Radiotherapy in Patients with Vestibular Schwannoma and Neurofibromatosis Type 2: Clinical Results and Review of the Literature. TUMORI JOURNAL 2018; 100:189-94. [DOI: 10.1177/030089161410000212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background To evaluate the long-term outcome of patients with vestibular schwannoma (VS) and neurofibromatosis type 2 (NF2) treated with fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS). Patients and Methods Sixteen VS in 14 patients with NF2 were treated with FSRT (n = 14) and SRS (n = 2). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. For patients treated with FSRT a median total dose of 57.6 Gy was prescribed with a median fractionation of 5 × 1.8 Gy per week. For patients who underwent SRS a median single dose of 17 Gy was prescribed to the 80% isodose. Results FSRT and SRS were well tolerated. Local control rate was 94% for a median follow-up time of 131 months; 2- and 5-year progression-free survival were 100%. The probability of maintaining the pretreatment hearing level was 44%. Useful hearing preservation was 33%. Cranial nerve toxicity was moderate. Trigeminal nerve function worsened in 2 patients (12%) and facial nerve function in 3 patients (19%). One patient developed a new tinnitus. Conclusion FSRT and SRS are both safe and effective noninvasive and minimally invasive treatment options for patients with VS in the setting of NF2. The long-term local control rates are excellent. Functional hearing preservation is worse in patients with VS and NF2 than in patients with sporadic VS.
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Affiliation(s)
- Johanna Wagner
- Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg
| | - Thomas Welzel
- Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg
| | - Daniel Habermehl
- Department of Radiation Oncology, Technical University Hospital of Munich, Munich, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg
| | - Stephanie E Combs
- Department of Radiation Oncology, Technical University Hospital of Munich, Munich, Germany
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Stereotactic radiotherapy of vestibular schwannoma. Strahlenther Onkol 2016; 193:200-212. [DOI: 10.1007/s00066-016-1086-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 11/14/2016] [Indexed: 01/24/2023]
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Clinical outcome of neurofibromatosis type 2-related vestibular schwannoma: treatment strategies and challenges. Neurosurg Rev 2016; 39:643-53. [DOI: 10.1007/s10143-016-0728-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 03/06/2016] [Accepted: 03/07/2016] [Indexed: 11/26/2022]
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Outcome on hearing and facial nerve function in microsurgical treatment of small vestibular schwannoma via the middle cranial fossa approach. Eur Arch Otorhinolaryngol 2012; 270:1209-16. [DOI: 10.1007/s00405-012-2074-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 05/31/2012] [Indexed: 11/25/2022]
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