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01-10-2018 | Clinical Study

Gamma knife radiosurgery for trigeminal schwannoma: a 20-year experience with long-term treatment outcome

Published in: Journal of Neuro-Oncology | Issue 1/2018

Abstract

Purpose

This study evaluated the long-term tumor control rate (TCR) and symptomatic outcomes of patients treated with gamma knife radiosurgery (GKRS) for trigeminal schwannomas (TSs).

Methods

Thirty-two patients with TS who underwent GKRS between January 1994 and January 2013 with at least 2 years of follow-up were enrolled in the study. Clinical charts and surgical records were retrospectively reviewed to evaluate factors affecting TCR and symptomatic outcomes. The median patient age was 57.5 years (max = 81, interquartile range [IQR] = 51–67), and the median tumor volume was 3.55 cm³ (max = 25.2 cm³, IQR = 2.0–6.2 cm³). The median marginal and maximum doses were 13.0 Gy (max = 18.0 Gy, IQR = 12.5–15 Gy) and 23.8 Gy (max = 35 Gy, IQR = 21.7–25.0 Gy), respectively.

Results

At a median follow-up of 90.5 months (max = 281 months, IQR = 49–139.75 months), the actuarial 3-, 5-, and 10-year TCR were 93.8, 86.2, and 80.8%, respectively. Our data and multivariate analysis indicated that the target volume was the only significant factor determining TCR and that larger tumors (> 5 cm³) were more likely to progress (p = 0.011). Cystic tumors had a higher incidence of transient enlargement and temporary symptom change compared to those in solid tumors. An unfavorable outcome of symptoms was observed in five patients (15.6%). Complications were observed in two patients (6.25%), including hydrocephalus and radio-induced trigeminal neuropathy, respectively.

Conclusions

GKRS can be a safe and effective treatment modality for TS with long-term follow-up, especially for small tumors. An extended period of follow-up observation is required to conclude the clinical response to GKRS.

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Title: Gamma knife radiosurgery for trigeminal schwannoma: a 20-year experience with long-term treatment outcome
Publication date: 01-10-2018
Published in: Journal of Neuro-Oncology / Issue 1/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2934-1

At a glance: The STEP trials

Springer Medicine

Gamma knife radiosurgery for trigeminal schwannoma: a 20-year experience with long-term treatment outcome

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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