Gamma Knife Surgery for Facial Nerve Schwannomas

Cf, Litré; Gp, Gourg; Tamura, Manabu; Ph, Roche; Régis, J.

doi:10.1159/000156899

Cited by 22 publications

(25 citation statements)

References 1 publication

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“…23 During the last 3 decades, SRS has emerged as another possible treatment option. There are several reports that showed the safety and efficacy of SRS for patients with FNSs, 2,3,5,17,18,21,22 but the reported studies generally included a small number of patients. To our knowledge, ours is the largest study to date of FNSs treated with SRS.…”

Section: Discussion Treatment Optionsmentioning

confidence: 99%

“…To our knowledge, ours is the largest study to date of FNSs treated with SRS. Litre et al 21 reported the results of FNSs treated with GKS; 8 of 9 patients who were followed up for more than 2 years had achieved good tumor control at the last follow-up, and only 1 patient had developed tumor enlargement with cyst formation. In our study, 41 (98%) of 42 patients showed good tumor control during a median follow-up period of 4 years.…”

Section: Discussion Treatment Optionsmentioning

confidence: 99%

“…In the 11 GKS-treated patients with FNSs described by Litre et al, 21 no patient experienced newly developed or worsened facial palsy, whereas 3 patients showed improvement in their pre-GKS facial palsy.…”

Section: Facial Nerve Functionmentioning

confidence: 94%

“…Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. Tumor location was classified as 1 of 4 types, as described by Litre et al 21 ( Table 3, Fig. 1).…”

Section: Methods Patient Characteristicsmentioning

confidence: 99%

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Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

Hasegawa

Kato

Kida

et al. 2016

JNS

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obJective The aim of this study was to explore the efficacy and safety of stereotactic radiosurgery for patients with facial nerve schwannomas (FNSs). methods This study was a multiinstitutional retrospective analysis of 42 patients with FNSs treated with Gamma Knife surgery (GKS) at 1 of 10 medical centers of the Japan Leksell Gamma Knife Society (JLGK1301). The median age of the patients was 50 years. Twenty-nine patients underwent GKS as the initial treatment, and 13 patients had previously undergone surgery. At the time of the GKS, 33 (79%) patients had some degree of facial palsy, and 21 (50%) did not retain serviceable hearing. Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. The median tumor volume was 2.5 cm 3 , and the median prescription dose to the tumor margin was 12 Gy. results The median follow-up period was 48 months. The last follow-up images showed partial remission in 23 patients and stable tumors in 19 patients. Only 1 patient experienced tumor progression at 60 months, but repeat GKS led to tumor shrinkage. The actuarial 3- and 5-year progression-free survival rates were 100% and 92%, respectively. During the follow-up period, 8 patients presented with newly developed or worsened preexisting facial palsy. The condition was transient in 3 of these patients. At the last clinical follow-up, facial nerve function improved in 8 (19%) patients, remained stable in 29 (69%), and worsened in 5 (12%; House-Brackmann Grade III in 4 patients, Grade IV in 1 patient). With respect to hearing function, 18 (90%) of 20 evaluated patients with a pure tone average of ≤ 50 dB before treatment retained serviceable hearing. coNclusioNs GKS is a safe and effective treatment option for patients with either primary or residual FNSs. All patients, including 1 patient who required repeat GKS, achieved good tumor control at the last follow-up. The incidence of newly developed or worsened preexisting facial palsy was 12% at the last clinical follow-up. In addition, the risk of hearing deterioration as an adverse effect of radiation was low. These results suggest that GKS is a safe alternative to resection.

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Section: Discussion Treatment Optionsmentioning

confidence: 99%

Section: Discussion Treatment Optionsmentioning

confidence: 99%

Section: Facial Nerve Functionmentioning

confidence: 94%

“…Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. Tumor location was classified as 1 of 4 types, as described by Litre et al 21 ( Table 3, Fig. 1).…”

Section: Methods Patient Characteristicsmentioning

confidence: 99%

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Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan

Hasegawa

Kato

Kida

et al. 2016

JNS

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“…Kida et al 18 reported a 100% tumor control rate of facial neuromas after a mean follow-up of 31 months with GKS. Litre et al 28 reported that 10 of 11 patients with facial schwannomas were stable after this same treatment. This group suggests that, given the advantages noted in the results of their study, these results should lead to the consideration of GKS as a primary treatment option for smallto medium-sized facial schwannomas.…”

Section: Schwannomasmentioning

confidence: 95%

Surgery and radiotherapy: complementary tools in the management of benign intracranial tumors

Johnson

Loredo

Slater

2008

FOC

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✓ Historically, radiation therapy has been used extensively in the treatment of malignant and aggressive intracranial tumors, and the importance of its role has been repeatedly verified by prolonged patient survival rates and increased tumor control. As more modern capabilities are employed in surgery and radiotherapy, attention is being directed to the utility of radiation as either primary or secondary treatment of benign tumors. Specifically, primary treatment encompasses irradiation of small benign tumors without biopsy confirmation of tumor type; secondary treatment involves postoperative radiation therapy, with the possibility that less-aggressive tumor resection may be performed in areas that have a higher probability of resultant neurological deficit. Current literature suggests that this is not only a possible treatment strategy, but that it may be superior to more radical resection in some cases, for example, in vestibular schwannomas and meningiomas. This article provides an overview of factors to consider in the use of radiation therapy and reviews the relationships between radiation and surgery, notably the unique complementary role each plays in the treatment of benign intracranial tumors.

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