Repeat Gamma Knife Surgery for Regrowth of Vestibular Schwannomas

Abstract

This is the first report to address repeat GKS for vestibular schwannomas. After long-term follow-up, repeat GKS with a low marginal dose seems to be a safe and effective treatment in selected patients harboring regrowth of small vestibular schwannomas that have previously been treated with GKS.

Vestibular Schwannoma Microsurgery for Recurrent Tumors After Radiation Therapy or Previous Surgical Resection

“…Liscak et al (11) reported that among 24 patients, who were followed up after repeat GKRS for a median of 43 months, 1 patient deteriorated in hearing function, 1 patient developed facial paresis, and 3 were described to have ''facial spasms.'' Other authors reported neither deterioration of facial nerve function nor hearing function after second GKRS (44,45).…”

Management of large vestibular schwannoma. Part I. Planned subtotal resection followed by Gamma Knife surgery: radiological and clinical aspects

“…Previous studies have shown a good response after a second GKS for VS once the primary GKS has failed, with a very low risk of complications. 32,64 One patient experienced an HB Grade III transient facial nerve paresis in the absence of lesion growth. One patient with a large progressive residual VS was surgically treated and had facial nerve paralysis postoperatively.…”

Radiobiology of vestibular schwannomas: mechanisms of radioresistance and potential targets for therapeutic sensitization

“…Some tumors are highly responsive to low doses of radiation, whereas others are highly radioresistant and tend to progress regardless of radiation dose. 36 Although radiation therapy is effective in selected patients (with tumor regression in 32% and tumor senescence in 59%), 9% of patients suffer tumor progression despite treatment. 12 Studies at the Karolinska Institute evaluated the dose-response relationships of irradiated VS tissue.…”