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Outcome after radiotherapy for vestibular schwannomas (VS): differences in tumor control, symptoms and quality of life after radiotherapy with photon versus proton therapy

Background: To evaluate differences in local tumor control (LC), symptoms and quality of life (QOL) of 261 patients with VS after stereotactic radiosurgery/hypofractionated stereotactic radiotherapy (SRS/HFSRT) vs. fractionated radiotherapy (FRT) vs. fractionated proton therapy (FPT) were studied. M...

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Main Authors: Küchler, Maike (Author) , El-Shafie, Rami (Author) , Adeberg, Sebastian (Author) , Herfarth, Klaus (Author) , König, Laila (Author) , Uzun-Lang, Kristin (Author) , Hörner-Rieber, Juliane (Author) , Plinkert, Peter K. (Author) , Wick, Wolfgang (Author) , Sahm, Felix (Author) , Sprengel, Simon David (Author) , Debus, Jürgen (Author) , Bernhardt, Denise (Author)
Format: Article (Journal)
Language:English
Published: 10 April 2022
In: Cancers
Year: 2022, Volume: 14, Issue: 8, Pages: 1-17
ISSN:2072-6694
DOI:10.3390/cancers14081916
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers14081916
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/14/8/1916
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Author Notes:Maike Küchler, Rami A. El Shafie, Sebastian Adeberg, Klaus Herfarth, Laila König, Kristin Lang, Juliane Hörner-Rieber, Peter Karl Plinkert, Wolfgang Wick, Felix Sahm, Simon David Sprengel, Jürgen Debus and Denise Bernhardt
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Summary:Background: To evaluate differences in local tumor control (LC), symptoms and quality of life (QOL) of 261 patients with VS after stereotactic radiosurgery/hypofractionated stereotactic radiotherapy (SRS/HFSRT) vs. fractionated radiotherapy (FRT) vs. fractionated proton therapy (FPT) were studied. Methods: For SRS/HFSRT (n = 149), the median fraction dose applied was 12 Gy. For FRT (n = 87) and FPT (n = 25), the median cumulative doses applied were 57.6 Gy and 54 Gy (RBE), respectively. FRT and FPT used single median doses of 1.8 Gy/Gy (RBE). Median follow-up was 38 months. We investigated dosimetry for organs at risk and analyzed toxicity and QOL by sending out a questionnaire. Results: LC was 99.5% at 12 months after RT with no statistical difference between treatment groups (p = 0.19). LC was significantly lower in NF2 patients (p = 0.004) and in patients with higher tumor extension grade (p = 0.039). The hearing preservation rate was 97% at 12 months after RT with no statistical difference between treatment groups (p = 0.31). Facial and trigeminal nerve affection after RT occurred as mild symptoms with highest toxicity rate in FPT patients. Conclusion: SRS/HFSRT, FRT and FPT for VS show similar overall clinical and functional outcomes. Cranial nerve impairment rates vary, potentially due to selection bias with larger VS in the FRT and FPT group.
Item Description:This article belongs to the special issue Proton Therapy for CNS Tumors
Gesehen am 15.09.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers14081916

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