Journal article
Stereotactic radiotherapy for trigeminal schwannomas
Neurosurgery, v 71(2), pp 270-277
01 Aug 2012
PMID: 22472550
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Data on radiotherapy for trigeminal schwannomas (TSs) and comparison of stereotactic radiosurgery (SRS) with fractionated stereotactic radiotherapy (FSRT) are limited.
We present a large retrospective review of our institutional experience treating TSs with SRS and FSRT. We also describe a flare phenomenon experienced by some patients.
The records of 23 consecutive TSs patients treated with radiotherapy between 1996 and 2011 were reviewed. We investigated radiographic response, tumor control, and toxicity.
Ten patients underwent SRS and 13 underwent FSRT, with median clinical follow-up of 32 months (range, 3-120 months). Tumor control at 5 and 10 years was 94% overall. Symptom control at 5 years was achieved in 48% of all patients, with nonsignificant improvement in more patients in the FSRT group than those in the SRS group (56% vs 40%, P = .37). Acute toxicity was higher in the FSRT group (38.5 vs 0%, P < .01), although lesions treated with FSRT were larger (mean, 9.5 mL vs 4.8 mL, P < .01). A symptomatic flare phenomenon occurred in 2 patients (8.7% overall) during FSRT, involving transient cystic formation and dramatic size increase. One lesion regressed in size and 1 remained stable on follow-up.
Tumor control rates for TSs are excellent with SRS and FSRT with minimal toxicity. This represents the first documented report of a flare phenomenon after FSRT for TS treatment. Flare risk after FSRT in previously resected large lesions should be discussed with patients before treatment, and prophylactic oral steroids may be considered.
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Details
- Title
- Stereotactic radiotherapy for trigeminal schwannomas
- Creators
- Colin E Champ - Thomas Jefferson UniversityMark V Mishra - Radiation Oncology AssociatesWenyin Shi - Radiation Oncology AssociatesJoshua Siglin - Radiation Oncology AssociatesMaria Werner-WasikDavid W Andrews - Neurological SurgeryJames J Evans - Sidney Kimmel Cancer Center
- Publication Details
- Neurosurgery, v 71(2), pp 270-277
- Publisher
- LWW
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000307109301010
- Scopus ID
- 2-s2.0-84864184712
- Other Identifier
- 991021897391804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Surgery