Universität zu Köln

Ruess, Daniel, Poehlmann, Lea, Hellerbach, Alexandra, Hamisch, Christina, Hoevels, Mauritius, Treuer, Harald, Grau, Stefan ORCID: 0000-0002-9742-527X, Jablonska, Karolina, Kocher, Martin and Ruge, Maximilian I. (2018). Acoustic Neuroma Treated with Stereotactic Radiosurgery: Follow-up of 335 Patients. World Neurosurg., 116. S. E194 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: To determine the clinical and radiologic outcome of patients with acoustic neuroma (AN) treated with linear accelerator (LINAC) or CyberKnife-based stereotactic radiosurgery with respect to tumor control, preservation of serviceable hearing, and toxicity. METHODS: A retrospective monocentric analysis including all patients who underwent single-fraction LINAC or CyberKnife-based radiosurgery for AN between 1991 and 2015. Patient data were analyzed in terms of radiologic and clinical tumor control (no further intervention needed), treatment-related complications, preservation of serviceable hearing, and objectified hearing loss using pure tone average levels. RESULTS: We included 335 patients (median age 58.2 years, treated either by LINAC-based [n = 270] or CyberKnife [n = 65] stereotactic radiosurgery). The median tumor volume was 1.1 ml (0.1-23.7 ml). The median radiation dose was 12 Gy (LINAC 12 Gy, 11-20 Gy; CyberKnife 13 Gy, 12-13 Gy) at an isodose level of 71.7% (LINAC 68.3%, 31.9%-86.2%; CyberKnife 80%, 65%-81%). The median follow-up was 30 months (LINAC 43 months, 2-224 months; CyberKnife 13 months, 4-37 months). Clinical tumor control was 98%, 89%, and 88% at 2, 5, and 10 years. The objective actuarial hearing preservation rate was 89%, 80%, and 55% at 1, 2, and 5 years. New symptoms were observed in 11.3% and classified as Common Terminology Criteria for Adverse Events grade 1/2, apart from 4 patients (1.2%), who developed Common Terminology Criteria for Adverse Events grade 3. CONCLUSIONS: Our study shows that in AN, high tumor control and considerable hearing preservation rates can be achieved by single-dose radiosurgery at low toxicity rates, resulting in a positive impact on long-term clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Poehlmann, Lea UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellerbach, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoevels, Mauritius UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED orcid.org/0000-0002-9742-527X UNSPECIFIED Jablonska, Karolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-177570
DOI:	10.1016/j.wneu.2018.04.149
Journal or Publication Title:	World Neurosurg.
Volume:	116
Page Range:	S. E194 - 9
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GAMMA-KNIFE RADIOSURGERY; EVIDENCE-BASED GUIDELINES; VESTIBULAR SCHWANNOMAS EVALUATION; LONG-TERM OUTCOMES; CLINICAL ARTICLE; TUMOR-CONTROL; ACCELERATOR-RADIOSURGERY; HEARING PRESERVATION; 10-YEAR EXPERIENCE; J NEUROSURG Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17757