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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Combined treatment of vestibular schwannoma: the therapeutic profile of radiosurgery in postoperatively recurrent or residual tumours

Kombinationsbehandlung von Vestibularisschwannomen: Das therapeutische Profil der Radiochirurgie bei postoperativ rezidivierten oder inkomplett resezierten Tumoren

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  • corresponding author B. Wowra - Europäisches CyberKnife Zentrum München-Großhadern, München
  • A. Muacevic - Europäisches CyberKnife Zentrum München-Großhadern, München
  • M. Kufeld - Europäisches CyberKnife Zentrum München-Großhadern, München
  • R. Goldbrunner - Neurochirurgische Universitätsklinik, München
  • J.-C. Tonn - Neurochirurgische Universitätsklinik, München

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.01.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc214.shtml

Published: May 30, 2008

© 2008 Wowra et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Aim of this study was to analyze the therapeutic impact of radiosurgery (RS) for patients with recurrent or residual VS after surgery.

Methods: Between 1/1995 and 6/2007, a total of 109 patients with recurrent or residual unilateral VS were treated based on a nation wide referral base. Outpatient RS was performed with either the Gamma Knife or the CyberKnife.

Results: Median tumour volume was 1,4 cm3 (range: 0,1 – 9,0). Median therapeutic dose to the tumour margin was 13 Gy (range: 9 – 16). The median follow-up time after radiosurgery was 7 years (range: 0,5 – 13). The actual tumour control rate amounted to 89% five years after RS (5 recurrences after RS). 101 patients had no serviceable hearing or were deaf before RS. RS did not affect this status. The serviceable hearing (class 1 – 3) in 8 patients tended to be reduced after RS by 1 class (statistically not significant). 5 (4,5%) patients experienced transient worsening of the facial nerve function after RS. Permanent facial nerve damage was not observed. Transient trigeminal nerve damage was found in 3 patients with tumour volumes over 7 cm3. 1 patient was found to have a flaring of cerebellar peduncle tissue adjacent to the VS seen in sequential MR imaging. This feature lasted for 6 months and was correlated with transient ataxia.

Conclusions: RS is a valuable method in the combined management of a sub-group of challenging VS.