| Hearing preservation after radiotherapy for vestibular schwannomas is comparable to hearing deterioration in healthy adults and is accompanied by local tumor control and a highly preserved quality of life (QOL) as patients' self-reported outcome. | |
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MedLine Citation:
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PMID: 23333012 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: To evaluate long-term results and patients' self-reported outcome of high-precision photon radiotherapy for the treatment of patients with vestibular schwannoma (VS). METHODS AND MATERIALS: We treated 246 patients with 248 VS with fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS). For FSRT, a median total dose of 57.6Gy was prescribed in median single doses of 1.8Gy, for SRS, a median dose of 13Gy/80% isodose was applied. Of all patients, 51 patients died during follow-up. To evaluate long-term toxicity and QOL, we sent out a questionnaire to all living patients; of these, 81 patients (42%) sent back the questionnaire. RESULTS: Median local control was 84months, actuarial local control rates for both groups (SRS and FSRT) were 98% after 2, 95% after 5, and 93% after 10years; there was no statistical difference between FSRT and SRS. Hearing deterioration was significantly higher in the SRS group than the FSRT group. However, when comparing FSRT to SRS with doses⩽13Gy, hearing preservation is comparable. In patients with useful hearing, hearing preservation was 89.7% at 1 year, 84.7% at 3years, 76.5% at 5years, and 68.6% at 10 years. After 10years of follow-up, hearing deterioration can be observed in both subgroups. In the FSRT group, facial nerve toxicity rate was 1.6%. Trigeminal nerve toxicity was observed in 2.1% after FSRT. Overall QOL was unchanged in 47% of the patients after RT, and 31% reported an improvement in QOL during follow-up. CONCLUSION: Patients' self-reported outcome confirms good results with respect to tumor control and QOL after FSRT or SRS in patients with VS. SRS can be associated with higher side effect following a dose-dependency. In long-term follow-up, hearing deterioration is most likely attributed to normal aging, but not treatment-related. |
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Authors:
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Stephanie E Combs; Thomas Welzel; Kerstin Kessel; Daniel Habermehl; Stefan Rieken; Oliver Schramm; Jürgen Debus |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-16 |
Journal Detail:
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Title: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology Volume: - ISSN: 1879-0887 ISO Abbreviation: Radiother Oncol Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8407192 Medline TA: Radiother Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany. Electronic address: Stephanie.combs@med.uni-heidelberg.de. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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