Non surgical treatment of vestibular schwannoma

Abstract

Introduction and objectives: To evaluate the results of local control and complications in the treatment of vestibular schwannoma treated with radiation.

Methods: A retrospective study of 194 patients diagnosed with vestibular schwannoma, treated consecutively with radiation (either stereotactic radiosurgery or fractionated radiotherapy) from 1997 to 2012. We analyze the local control of tumors, as well as secondary complications to treatment with radiation.

Results: A total of 132 (68%) tumors 68% are grade I-II tumors of the Koos classification, 40 (19%) are grade III, and 22 (13%) are grade IV. The tumors associated with neurofibromatosis (NF2), are 3.6% (6 tumors in 4 patients). The tumor control for the overall serie is 97% at 5 years, with a median follow-up of 80.4 months. For large tumors the local control is 91% at 5 years. Free survival of chronic complications is 89% at 5 years. Additionally, 50 tumors were subjected to regular follow-up with MRI without treatment, and 28 (58%) did not experienced tumor growth.

Conclusions: Radiation and follow up with MRI, are an alternative to surgery in the treatment of vestibular schwannoma, with a low level of complications inside of multidisciplinary approach.

Keywords: Acoustic neuroma; Fractionated stereotactic radiotherapy; Neurinoma acústico; Observación; Observation; Radiocirugía; Radiosurgery; Radioterapia estereotáctica fraccionada; Schwannoma vestibular; Vestibular schwannoma.