Artikel
Radiotherapy of vestibular schwannoma: effect on the hearing
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Veröffentlicht: | 8. Juli 2008 |
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Gliederung
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Today, radiotherapy is considered to be a gentle treatment option in vestibular schwannoma therapy. Hearing, in particular, is supposed to be preserved better than in the microsurgical approach. The aim of this study was to evaluate how and when the hearing changed after singular or fractionated radiotherapy.
Method: 72 patients (34 female, 38 male), on average 60 years old (32 to 81), were treated with radiotherapy in a prospective trial. Depending on the tumor size, 50 patients were treated „radiosurgically“ (RS, singular 12 Gy), and 22 patients received a stereotactic, fractionated radiotherapy (SFR, cumulative dose 54 Gy). Therapy was conducted between February 1998 and May 2007, with an average follow-up of 3,4 years.
Results: The average absolute hearing loss on the radiated ear in the pure tone audiogram was 13 dB for RC and 19 dB for SFR. All frequencies were affected to the same extent. This hearing loss was progressing slowly and occurred within the first 2,5 years after RC and within the first 3,5 years after SFR. 8 patients (11%) experienced a lasting hearing improvement after the radiotherapy of 7 dB on average. 4 patients (6%), in contrast, suffered a hearing loss of more than 40 dB. The hearing loss was very variable and did not correlate with tumor size or dose of radiation.
Conclusion: Radiotherapy of vestibular schwannomas results in a slow, over 2.5–3.5 years, progressing average hearing loss of 13 to 19 dB. Hearing loss is very variable, and hearing improvement was observed in 11% of the patients.