Fractionated radiation therapy for vestibular schwannoma

Brian J. Jian, Gurvinder Kaur, Eli T. Sayegh, Orin Bloch, Andrew T. Parsa, Igor J. Barani

Research output: Contribution to journalReview article

7 Scopus citations

Abstract

Vestibular schwannomas are the most common tumors of the cerebellopontine angle. Multiple management paradigms exist for patients with these benign tumors, including observation, microsurgery, stereotactic radiosurgery, and fractionated radiation therapy, or some combination of these. While the proper course of management is controversial, the goals of therapy are to achieve excellent local tumor control and optimize functional outcomes with as little treatment-related morbidity as possible. Decision-making is tailored to patient-specific factors such as tumor size, clinical presentation, patient age, and goals of hearing preservation. We review the literature in order to summarize the application of fractionated radiation therapy to this tumor entity, where it is used as a primary treatment or, more commonly, as an adjunct therapy. We also provide an overview of the use of fractionated radiation therapy for the preservation of hearing and facial function, and dosing and other technical considerations, in light of the indolent natural history of vestibular schwannomas. We also discuss potential risks associated with this treatment modality, including its effects on temporal bone structures and cranial nerves among other possible complications. Lastly, we outline future directions in this rapidly evolving segment of vestibular schwannoma therapy, which has benefited from the advent of intensity-modulated radiation therapy coupled with stereotactic localization.

Original languageEnglish (US)
Pages (from-to)1083-1088
Number of pages6
JournalJournal of Clinical Neuroscience
Volume21
Issue number7
DOIs
StatePublished - Jul 2014
Externally publishedYes

Keywords

  • Facial preservation
  • Fractionated radiotherapy
  • Hearing preservation
  • Risks
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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  • Cite this

    Jian, B. J., Kaur, G., Sayegh, E. T., Bloch, O., Parsa, A. T., & Barani, I. J. (2014). Fractionated radiation therapy for vestibular schwannoma. Journal of Clinical Neuroscience, 21(7), 1083-1088. https://doi.org/10.1016/j.jocn.2013.11.005