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Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases

Abstract

Purpose: To evaluate long-term outcomes and efficacy of fractionated stereotactic radiotherapy in the treatment of acoustic neuromas. Material and methods: Between January 1996 and December 2009, 158 acoustic neuromas were treated by FSR in 155 patients. They received a dose of 50.4 Gy, with a safety margin of 1–2 mm with a median tumor volume at 2.45 mL (range: 0.17–12.5 mL) and a median follow-up duration at 60 months (range: 24–192). Results: FSR was well tolerated in all patients with mild sequelae consisting in radiation-induced trigeminal nerve impairments (3.2%), Grade 2 facial neuropathies (2.5%), new or aggravated tinnitus (2.1%) and VP shunting (2.5%). The treatment failed in four patients (2.5%) who had subsequent surgery respectively at 20, 38, 45 and 84 months post-FSR. The local tumor control rates were respectively 99.3%, 97.5% and 95.2% at 3, 5 and >7-year of follow-up. For initial Gardner–Robertson Grade 1 and 2 ANs, the preservation of useful hearing was possible in 54% of the cases; only Grade 1 ANs had stabilized during the course of the follow-up with 71% >7 years. However, hearing preservation was not correlated to the initial Koos Stage and to the radiation dose delivered to the cochlea. Tinnitus (70%), vertigo  More>>
Authors:
Litre, Fabien; [1]  Rousseaux, Pascal; [1]  Jovenin, Nicolas; [2]  Bazin, Arnaud; Peruzzi, Philippe; [1]  Wdowczyk, Didier; Colin, Philippe [3] 
  1. Hôpital Maison Blanche, Reims Cedex (France)
  2. Institut Jean Godinot, Reims Cedex (France)
  3. Institut du Cancer Reims Courlancy, Reims (France)
Publication Date:
Feb 15, 2013
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 106; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AUDITORY ORGANS; BYPASSES; HEALTH HAZARDS; LOSSES; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SAFETY MARGINS; SURGERY
OSTI ID:
22258422
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; CODEN: RAONDT; Other: PII: S0167-8140(12)00463-X; TRN: IE14R0002079632
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2012.10.013
Submitting Site:
INIS
Size:
page(s) 169-174
Announcement Date:
Aug 22, 2014

Citation Formats

Litre, Fabien, Rousseaux, Pascal, Jovenin, Nicolas, Bazin, Arnaud, Peruzzi, Philippe, Wdowczyk, Didier, and Colin, Philippe. Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases. Ireland: N. p., 2013. Web. doi:10.1016/J.RADONC.2012.10.013.
Litre, Fabien, Rousseaux, Pascal, Jovenin, Nicolas, Bazin, Arnaud, Peruzzi, Philippe, Wdowczyk, Didier, & Colin, Philippe. Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases. Ireland. doi:10.1016/J.RADONC.2012.10.013.
Litre, Fabien, Rousseaux, Pascal, Jovenin, Nicolas, Bazin, Arnaud, Peruzzi, Philippe, Wdowczyk, Didier, and Colin, Philippe. 2013. "Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases." Ireland. doi:10.1016/J.RADONC.2012.10.013. https://www.osti.gov/servlets/purl/10.1016/J.RADONC.2012.10.013.
@misc{etde_22258422,
title = {Fractionated stereotactic radiotherapy for acoustic neuromas: A prospective monocenter study of about 158 cases}
author = {Litre, Fabien, Rousseaux, Pascal, Jovenin, Nicolas, Bazin, Arnaud, Peruzzi, Philippe, Wdowczyk, Didier, and Colin, Philippe}
abstractNote = {Purpose: To evaluate long-term outcomes and efficacy of fractionated stereotactic radiotherapy in the treatment of acoustic neuromas. Material and methods: Between January 1996 and December 2009, 158 acoustic neuromas were treated by FSR in 155 patients. They received a dose of 50.4 Gy, with a safety margin of 1–2 mm with a median tumor volume at 2.45 mL (range: 0.17–12.5 mL) and a median follow-up duration at 60 months (range: 24–192). Results: FSR was well tolerated in all patients with mild sequelae consisting in radiation-induced trigeminal nerve impairments (3.2%), Grade 2 facial neuropathies (2.5%), new or aggravated tinnitus (2.1%) and VP shunting (2.5%). The treatment failed in four patients (2.5%) who had subsequent surgery respectively at 20, 38, 45 and 84 months post-FSR. The local tumor control rates were respectively 99.3%, 97.5% and 95.2% at 3, 5 and >7-year of follow-up. For initial Gardner–Robertson Grade 1 and 2 ANs, the preservation of useful hearing was possible in 54% of the cases; only Grade 1 ANs had stabilized during the course of the follow-up with 71% >7 years. However, hearing preservation was not correlated to the initial Koos Stage and to the radiation dose delivered to the cochlea. Tinnitus (70%), vertigo (59%), imbalance (46%) and ear mastoid pain (43%) had greatly improved post-FRS in most patients. Tumor control, hearing preservation and FRS toxicity were quite similar in patients with NF2, cystic acoustic neuroma, prior surgical resection and Koos Stage 4 AN. No secondary tumors were observed. Conclusion: FSR is a safe and effective therapeutic for acoustic neuromas and could be an alternative to microsurgery. Compared to radiosurgery, there are no contraindications for fractioned doses of stereotactic radiotherapy especially for Stage-4 tumors and patients at high risk of hearing loss.}
doi = {10.1016/J.RADONC.2012.10.013}
journal = {Radiotherapy and Oncology}
issue = {2}
volume = {106}
journal type = {AC}
place = {Ireland}
year = {2013}
month = {Feb}
}