Medicine Science (Sep 2023)

Stereotactic radiotherapy in acoustic neuroma cases: Tumor control and clinical results

  • Ela Delikgoz Soykut,
  • Nilgun Sahin,
  • Eylem Odabasi,
  • Donay Aksan,
  • Ayse Cecen,
  • Hatice Tataroglu

DOI
https://doi.org/10.5455/medscience.2023.07.114
Journal volume & issue
Vol. 12, no. 3
pp. 933 – 40

Abstract

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Since acoustic neuromas (AN) are slow-growing tumors, they frequently reduce patients' quality of life by compressing adjacent nerves. After evaluating various factors, the most appropriate treatment for the patient is preferred among follow-up, surgery, or radiotherapy. Surgery and radiotherapy have been shown to have comparable results in AN. Stereotactic radiotherapy (SRT) has long emerged as a viable option for treating intracranial tumors. Thus, it was aimed to determine the local control rate (LCR), and treatment failure and to evaluate the hearing level and facial nerve symptoms in AN treated with SRT. Forty-five patients were treated consecutively with CyberKnife-SRT between January 2014 and December 2021. Tumors were anatomically classified according to Koos grade; patients presenting with hearing impairment were graded according to the Gardner-Robertson (GR) scale and patients' expressions. Loss of function in the facial nerve was also evaluated according to the House-Brackman scale. SRT was applied to 24 patients with 12 Gy/1 fx, 18 with 18 Gy/3 fx, and 3 with 25 Gy/5 fx. At a median follow-up of 24 months (2-73), progression was detected in 4 (8.9%) patients. None required additional intervention, and no treatment failure was observed (0%). Tumor control was achieved in 91.1% of the patients; 2-y and 5-y LCR were 91.2% and 79.8%. It was observed that 3 (30%) out of 10 patients who had serviceable hearing according to the GR scale at the beginning were non-serviceable hearing during the follow-up. Transient facial paralysis was observed in 3 (6.7%) patients. No statistically significant factor could be detected in LCR, hearing, and facial nerve preservation. Our findings are similar to previous SRT data regarding LCR, treatment failure, hearing preservation, and facial nerve impairment. SRT is an effective treatment method for AN with reasonable results. [Med-Science 2023; 12(3.000): 933-40]

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