Trends in the Management of Non-Vestibular Skull Base and Intracranial Schwannomas

Suárez, Carlos; López, Fernando; Mendenhall, William M.; Andreasen, Simon; Mikkelsen, Lauge Hjorth; Langendijk, Johannes A.; Bondi, Stefano; Rodrigo, Juan P.; Bäck, Leif; Mäkitie, Antti; Fernández-Álvarez, Verónica; Coca‐Pelaz, Andrés; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

doi:10.2147/cmar.s287410

Cited by 7 publications

(8 citation statements)

References 83 publications

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“…As far as the clinical improvement is concerned, hoarseness of voice and swallowing disturbances improved in 66%-63%, respectively, in their study. Factors associated with decreased tumor control include dumbbell-type tumors, brainstem edema, and tumor volume >6 cm 3 [11].…”

Section: Discussionmentioning

confidence: 99%

Jugular foramen schwannoma: A rare tumor treated by stereotactic radiosurgery

Bansal¹,

Jindal²,

Jindal³

et al. 2022

Indian J Case Reports

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Jugular foramen schwannomas (JFS) are rare benign tumors located in the jugular foramen. They can present with various symptoms depending on the extent of involvement of the tumor such as hearing loss, tinnitus, headache, and ataxia. Surgical resection has been considered as the primary treatment option for JFS. Stereotactic radiosurgery (SRS) offers an equally good treatment in patients with small and residual tumors after surgery with the advantage of being non-invasive with minimal complication rates. Herein, we present a rare case of JFS treated by SRS in our institution.

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Section: Discussionmentioning

confidence: 99%

Jugular foramen schwannoma: A rare tumor treated by stereotactic radiosurgery

Bansal¹,

Jindal²,

Jindal³

et al. 2022

Indian J Case Reports

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“…With an advanced skull base endoscopic approach, surgical resection is the mainstay of treatment. In the surgical series, 67%–90% of patients achieved total tumor removal, but the newly developed morbidity rates were 5%–62%, and mortality rates were 0%–3%[ 73 ]. The morbidity of resection is still relatively high, depending on the size and location of the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…SRS technique possesses safety advantages and reduces the rates of symptoms deterioration to 0-16%[ 74 75 76 77 78 ]. Unlike VS, NVCNS had a lower 5-year tumor growth control rate when treated with SRS alone, being around 80%[ 73 79 80 81 ]. Among our six NVCNS patients, one patient showed tumor growth with deterioration of neurological symptoms and required microsurgery at 8 months after SRS.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery

Lin¹,

Chew²,

Chen³

et al. 2022

Tzu Chi Medical Journal

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Objectives: Accelerator-based stereotactic radiosurgery (SRS) is a noninvasive and effective treatment modality widely used for benign brain tumors. This study aims to report 20-year treatment outcomes in our institute. Materials and Methods: From May 2001 to December 2020, 127 patients treated with LINAC-based single-fraction SRS for their benign brain lesions were included. A neurosurgeon and two radiation oncologists retrospectively reviewed all data. Computed tomography (CT) simulation was performed after head-frame fixation under local anesthesia. All planning CT images were co-registered and fused with gadolinium-enhanced magnetic resonance imaging taken within 3 months for lesions targeting and critical organs delineation. The marginal dose was prescribed at 60%–90% isodose lines, respectively, to cover ≥95% planning target volume. Outcome evaluations included clinical tumor control rate (TCR), defined as the need for salvage therapy, and radiological response, defined as no enlargement of >2 cm in the maximal diameter. Overall survival (OS) and adverse reaction (defined according to CTCAE 5.0) were also analyzed. Results: The present study included 76 female and 51 male patients for analysis. The median age was 59 years (range, 20–88 years). Their diagnoses were vestibular schwannoma (VS, n = 54), nonvestibular cranial nerve schwannoma ( n = 6), meningioma ( n = 50), and pituitary adenoma ( n = 17). Totally 136 lesions were treated in a single fraction, predominantly skull base tumors, accounting for 69.1%. Median and mean follow-up duration was 49 and 61 months (range, 1–214 months), Overall TCR was 92.9%. The 5-year disease-specific TCR for VS, nonvestibular schwannoma, meningioma, and pituitary adenoma were 97.4%, 91.7%, 93.8%, and 83.3%. Salvage therapy was indicated for eight patients at 4–110 months after SRS. Among symptomatic patients, post-SRS symptom(s) was improved, stable, and worse in 68.2%, 24.3%, and 3.6%, respectively. Radiological response rate for 111 evaluable patients was 94.6% (shrinkage, 28.8%; stable, 65.8%). OS was 96.1% without treatment-related mortality. One patient with post-SRS cranial nerve injury (0.8%, involving the trigeminal nerve, grade 2 toxicities). No grade 3–4 acute or late toxicity was found. Conclusion: Our results suggested that LINAC-based SRS effectively controls tumor growth and tumor-related neurological symptoms for patients with benign brain tumors. SRS is less aggressive, associated with low neurological morbidity and no mortality. Continuous follow-up is indicated to conclude longer outcomes.

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“…Schwannomas are benign low-growing nerve sheath tumors that occur in the head and neck area in the 25–50% of total cases [1] , [2] , [3] . The sinus-nasal involvement is even uncommon and represents less than 4% of all head and neck schwannomas [3] , [4] .…”

Section: Introductionmentioning

confidence: 99%

“…The sinus-nasal involvement is even uncommon and represents less than 4% of all head and neck schwannomas [3] , [4] . In the literature approximately 100 cases of intranasal schwannomas have been reported so far [1] , [2] , [3] . From a clinical standpoint, they often appear as slowly growing formation with progressive nasal obstruction with or without epistaxis, hyposmia and headaches [5] .…”

Section: Introductionmentioning

confidence: 99%