Stereotactic radiosurgery of cranial nonvestibular schwannomas: Results of single-and multisession radiosurgery

Clara Y.H. Choi, Scott G. Soltys, Iris C. Gibbs, Griffith R. Harsh, Gordon T. Sakamoto, Deep A. Patel, Robert E. Lieberson, Steven D. Chang, John R. Adler

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

BACKGROUND: Surgical resection of nonvestibular cranial schwannomas carries a considerable risk of postoperative complications. Stereotactic radiosurgery (SRS) offers a non-invasive treatment alternative. The efficacy and safety of multi-session SRS of nonvestibular cranial schwannomas has not been well studied. OBJECTIVE: To analyze the results of single-and multi-session SRS of nonvestibular cranial schwannomas. METHODS: From 2001 to 2007, 42 lesions in 40 patients were treated with SRS at Stanford University Medical Center, targeting schwannomas of cranial nerves IV (n = 1), V (n = 18), VII (n = 6), X (n = 5), XII (n = 2), jugular foramen (n = 8), and cavernous sinus (n = 2). SRS was delivered to a median marginal dose of 18 Gy (range, 15-33 Gy) in 1 to 3 sessions, targeting a median tumor volume of 3.2 cm 3 (range, 0.1-23.7 cm 3). The median doses for treatments in 1 (n = 18), 2 (n = 9), and 3 (n = 15) sessions were 17.5, 20, and 18 Gy, respectively. RESULTS: With a median follow-up of 29 months (range, 6-84 months), tumor control was achieved in 41 of the 42 lesions. Eighteen of 42 lesions (43%) decreased in size; 23 tumors (55%) remained stable. There were 2 cases of new or worsening cranial nerve deficits in patients treated in single session; no patient treated with multi-session SRS experienced any cranial nerve toxicity (P = 0.18). CONCLUSION: SRS of nonvestibular cranial schwannomas provides excellent tumor control with minimal risk of complications. There was a trend towards decreased complications with multi-session SRS.

Original languageEnglish (US)
Pages (from-to)1200-1208
Number of pages9
JournalNeurosurgery
Volume68
Issue number5
DOIs
StatePublished - May 2011
Externally publishedYes

Keywords

  • CyberKnife
  • Multisession
  • Nonvestibular schwannoma
  • Radiation
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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