Hearing preservation after radiotherapy for vestibular schwannomas is comparable to hearing deterioration in healthy adults and is accompanied by local tumor control and a highly preserved quality of life (QOL) as patients’ self-reported outcome
Purpose - To evaluate long-term results and patients’ self-reported outcome of high-precision photon radiotherapy for the treatment of patients with vestibular schwannoma (VS). - Methods and materials - We treated 246 patients with 248 VS with fractionated stereotactic radiotherapy (FSRT) or stereot...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
17 January 2013
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| In: |
Radiotherapy and oncology
Year: 2013, Volume: 106, Issue: 2, Pages: 175-180 |
| ISSN: | 1879-0887 |
| DOI: | 10.1016/j.radonc.2012.12.004 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.radonc.2012.12.004 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0167814012005324 
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| Author Notes: | Stephanie E. Combs, Thomas Welzel, Kerstin Kessel, Daniel Habermehl, Stefan Rieken, Oliver Schramm, Jürgen Debus |
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| 245 | 1 | 0 | |a Hearing preservation after radiotherapy for vestibular schwannomas is comparable to hearing deterioration in healthy adults and is accompanied by local tumor control and a highly preserved quality of life (QOL) as patients’ self-reported outcome |c Stephanie E. Combs, Thomas Welzel, Kerstin Kessel, Daniel Habermehl, Stefan Rieken, Oliver Schramm, Jürgen Debus |
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| 520 | |a Purpose - To evaluate long-term results and patients’ self-reported outcome of high-precision photon radiotherapy for the treatment of patients with vestibular schwannoma (VS). - Methods and materials - We treated 246 patients with 248 VS with fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS). For FSRT, a median total dose of 57.6Gy was prescribed in median single doses of 1.8Gy, for SRS, a median dose of 13Gy/80% isodose was applied. Of all patients, 51 patients died during follow-up. To evaluate long-term toxicity and QOL, we sent out a questionnaire to all living patients; of these, 81 patients (42%) sent back the questionnaire. - Results - Median local control was 84months, actuarial local control rates for both groups (SRS and FSRT) were 98% after 2, 95% after 5, and 93% after 10years; there was no statistical difference between FSRT and SRS. Hearing deterioration was significantly higher in the SRS group than the FSRT group. However, when comparing FSRT to SRS with doses⩽13Gy, hearing preservation is comparable. In patients with useful hearing, hearing preservation was 89.7% at 1 year, 84.7% at 3years, 76.5% at 5years, and 68.6% at 10 years. After 10years of follow-up, hearing deterioration can be observed in both subgroups. In the FSRT group, facial nerve toxicity rate was 1.6%. Trigeminal nerve toxicity was observed in 2.1% after FSRT. Overall QOL was unchanged in 47% of the patients after RT, and 31% reported an improvement in QOL during follow-up. - Conclusion - Patients’ self-reported outcome confirms good results with respect to tumor control and QOL after FSRT or SRS in patients with VS. SRS can be associated with higher side effect following a dose-dependency. In long-term follow-up, hearing deterioration is most likely attributed to normal aging, but not treatment-related. | ||
| 650 | 4 | |a Acoustic neuroma | |
| 650 | 4 | |a Hearing preservation | |
| 650 | 4 | |a Local control | |
| 650 | 4 | |a Radiation | |
| 650 | 4 | |a Radiosurgery | |
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