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Hypofractionated stereotactic radiotherapy for acoustic neuromas: safety and effectiveness over 8 years of experience

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Abstract

Background

Little information is available about long-term outcomes of hypofractionated stereotactic radiotherapy (hypo-FSRT) for acoustic neuromas. In this study, the safety and effectiveness of hypo-FSRT for unilateral acoustic neuroma were reviewed over 8 years of experience at our institution.

Methods

Between May 1998 and October 2006, 27 patients were consecutively treated by linear accelerator-based hypo-FSRT. Two patients were excluded from this study because they were lost to follow-up within 12 months. The median follow-up period for the rest was 59 (range 24–133) months. Two types of treatment schedules were adopted. Thirteen patients received 30–39 Gy, given in 10–13 fractions (regimen A), whereas after July 2003, 12 patients received 20–24 Gy, given in 5–6 fractions at the tumor periphery (regimen B). These treatments were scheduled to be delivered in three fractions per week (Monday, Wednesday, Friday). The median planning target volume was 2.0, with 1.7 ml (range 0.7–10.6) in regimen A and 5.2 ml (range 0.9–9.3) in regimen B. In the pretreatment audiogram, seven patients (two in regimen A and five in regimen B) had serviceable hearing (Gardner–Robertson Class I–II).

Results

Local control rates were 100% with regimen A and 92% with regimen B. Serviceable hearing was preserved in four of five patients in regimen B but no patients in regimen A at the last follow-up. No permanent facial or trigeminal nerve morbidity was observed following treatment, and no salvage surgery was needed.

Conclusions

Hypo-FSRT for acoustic neuromas achieved a high local control rate with minimal facial and trigeminal nerve morbidity.

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Acknowledgments

This work was partially supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (20229009) of Japan and Grants-in-Aid for Scientific Research on Priority Areas of Cancer from the Ministry of Education, Culture, Sports, Science, and Technology (17016036).

Conflict of interest

No author has any conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, 54 Sho-goin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Katsuyuki Sakanaka, Takashi Mizowaki & Masahiro Hiraoka

  2. Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Sho-goin Kawahara-cho, Sakyo-ku, Kyoto, Japan

    Yoshiki Arakawa, Nobuhiro Mikuni & Susumu Miyamoto

  3. Department of Radiology, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, Japan

    Norio Araki

  4. Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan

    Natsuo Oya

  5. Department of Neurosurgery, Kitano Hospital, 2-4-20 Ohgimachi, Kita-ku, Osaka, Japan

    Jun A. Takahashi

  6. National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan

    Nobuo Hashimoto

Authors
  1. Katsuyuki Sakanaka
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  2. Takashi Mizowaki
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  3. Yoshiki Arakawa
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  4. Norio Araki
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  5. Natsuo Oya
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  7. Nobuhiro Mikuni
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  8. Susumu Miyamoto
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  9. Nobuo Hashimoto
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  10. Masahiro Hiraoka
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Corresponding author

Correspondence to Takashi Mizowaki.

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Sakanaka, K., Mizowaki, T., Arakawa, Y. et al. Hypofractionated stereotactic radiotherapy for acoustic neuromas: safety and effectiveness over 8 years of experience. Int J Clin Oncol 16, 27–32 (2011). https://doi.org/10.1007/s10147-010-0122-1

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  • DOI: https://doi.org/10.1007/s10147-010-0122-1

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