Vestibular Schwannoma

  • Katelyn M. Atkins
  • Marc Bussière
  • Helen A. ShihEmail author


Vestibular schwannoma is a benign intracranial tumor. It is also called acoustic neurinoma. It usually causes progressive hearing loss and tinnitus. Stereotactic radiosurgery and conventionally fractionated radiotherapy have well-established track records with high local control rates and robust long-term follow-up data. This chapter summarizes hypofractionated radiotherapy techniques, including SRS and FSRT, for vestibular schwannomas.


Vestibular schwannomas Acoustic neurinoma Stereotactic radiosurgery SRS FSRT 


  1. 1.
    Brackmann DE, Owens RM, Friedman RA, Hitselberger WE, De la Cruz A, House JW, et al. Prognostic factors for hearing preservation in vestibular schwannoma surgery. Am J Otol. 2000;21(3):417–24.CrossRefPubMedGoogle Scholar
  2. 2.
    Betchen SA, Walsh J, Post KD. Long-term hearing preservation after surgery for vestibular schwannoma. J Neurosurg. 2005;102(1):6–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Khrais T, Sanna M. Hearing preservation surgery in vestibular schwannoma. J Laryngol Otol. 2006;120(5):366–70.CrossRefPubMedGoogle Scholar
  4. 4.
    Koos WT, Spetzler RF, Lang J. Color atlas of microneurosurgery. 2nd ed. Stuttgart: Thieme; 1993.Google Scholar
  5. 5.
    Wackym PA. Stereotactic radiosurgery, microsurgery, and expectant management of acoustic neuroma: basis for informed consent. Otolaryngol Clin N Am. 2005;38(4):653–70.CrossRefGoogle Scholar
  6. 6.
    Lee NY, Riaz N, Lu JJ. Target volume delineation and field setup: a practical guide for conformal and intensity-modulated radiation therapy. Heidelberg: Springer; 2015.CrossRefGoogle Scholar
  7. 7.
    Balagamwala EH, Suh JH, Barnett GH, Khan MK, Neyman G, Cai RS, et al. The importance of the conformality, heterogeneity, and gradient indices in evaluating gamma knife radiosurgery treatment plans for intracranial meningiomas. Int J Radiat Oncol Biol Phys. 2012;83(5):1406–13.CrossRefPubMedGoogle Scholar
  8. 8.
    Williams JA. Fractionated stereotactic radiotherapy for acoustic neuromas. Int J Radiat Oncol Biol Phys. 2002;54(2):500–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Kapoor S, Batra S, Carson K, Shuck J, Kharkar S, Gandhi R, et al. Long-term outcomes of vestibular schwannomas treated with fractionated stereotactic radiotherapy: an institutional experience. Int J Radiat Oncol Biol Phys. 2011;81(3):647–53.CrossRefPubMedGoogle Scholar
  10. 10.
    Kano H, Kondziolka D, Khan A, Flickinger JC, Lunsford LD. Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma. J Neurosurg. 2009;111(4):863–73.CrossRefPubMedGoogle Scholar
  11. 11.
    Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. Stereotactic body radiation therapy: the report of AAPM task group 101. Med Phys. 2010;37(8):4078–101.CrossRefPubMedGoogle Scholar
  12. 12.
    Marks LB, Yorke ED, Jackson A, Ten Haken RK, Constine LS, Eisbruch A, et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S10–9.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Fukuoka S, Takanashi M, Hojyo A, Konishi M, Tanaka C, Nakamura H. Gamma knife radiosurgery for vestibular schwannomas. Prog Neurol Surg. 2009;22:45–62.PubMedGoogle Scholar
  14. 14.
    Murphy ES, Barnett GH, Vogelbaum MA, Neyman G, Stevens GH, Cohen BH, et al. Long-term outcomes of gamma knife radiosurgery in patients with vestibular schwannomas. J Neurosurg. 2011;114(2):432–40.CrossRefPubMedGoogle Scholar
  15. 15.
    Prasad D, Steiner M, Steiner L. Gamma surgery for vestibular schwannoma. J Neurosurg. 2000;92(5):745–59.CrossRefPubMedGoogle Scholar
  16. 16.
    Hasegawa T, Fujitani S, Katsumata S, Kida Y, Yoshimoto M, Koike J. Stereotactic radiosurgery for vestibular schwannomas: analysis of 317 patients followed more than 5 years. Neurosurgery. 2005;57(2):257–65; discussion-65CrossRefPubMedGoogle Scholar
  17. 17.
    Friedman WA, Bradshaw P, Myers A, Bova FJ. Linear accelerator radiosurgery for vestibular schwannomas. J Neurosurg. 2006;105(5):657–61.CrossRefPubMedGoogle Scholar
  18. 18.
    Chopra R, Kondziolka D, Niranjan A, Lunsford LD, Flickinger JC. Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys. 2007;68(3):845–51.CrossRefPubMedGoogle Scholar
  19. 19.
    Kalapurakal JA, Silverman CL, Akhtar N, Andrews DW, Downes B, Thomas PR. Improved trigeminal and facial nerve tolerance following fractionated stereotactic radiotherapy for large acoustic neuromas. Br J Radiol. 1999;72(864):1202–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Meijer OW, Vandertop WP, Baayen JC, Slotman BJ. Single-fraction vs. fractionated linac-based stereotactic radiosurgery for vestibular schwannoma: a single-institution study. Int J Radiat Oncol Biol Phys. 2003;56(5):1390–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Katelyn M. Atkins
    • 1
  • Marc Bussière
    • 2
  • Helen A. Shih
    • 2
    Email author
  1. 1.Department of Radiation OncologyMassachusetts General HospitalBostonUSA
  2. 2.Department of Radiation OncologyMassachusetts General Hospital, Francis H. Burr Proton Therapy CenterBostonUSA

Personalised recommendations