CyberKnife radiosurgery for Trigeminal Schwannomas
Journal
Neurosurgery
Journal Volume
64
Journal Issue
2 SUPPL.
Pages
A14-A18
Date Issued
2009
Author(s)
Abstract
OBJECTIVE: Trigeminal schwannomas (TS) are benign tumors that are managed by surgical resection and/or stereotactic radiosurgery. Most radiosurgical series report results using the gamma knife. The CyberKnife (Accuray, Inc., Sunnyvale, CA) is a frameless, robotic stereotactic radiosurgical system. In this series, we report our experience using the CyberKnife in the treatment of TS. METHODS: We retrospectively reviewed the medical records and diagnostic imaging in 13 consecutive patients with TS who were treated with the CyberKnife from 2003 to 2007. Seven patients had a previous surgical resection. The mean tumor volume was 6.3 mL (range, 0.39-19.98 mL), and the mean marginal dose was 18.5 Gy. Six of the tumors were treated in a single session. The mean clinical follow-up period was 21.8 months (range, 7-53 months). RESULTS: In this series, the tumor control rate was 100%. The average reduction in tumor volume was 45% (range, 14-98%). A modest improvement in facial pain was noted in 4 of the 6 patients who presented with this symptom. One patient had improvement in facial numbness, and another had improvement in pretreatment headaches. One patient developed jaw weakness and facial dysesthesia, and another patient developed asymptomatic radiation necrosis. CONCLUSION: Although the length of follow-up is limited, we report our initial experience with CyberKnife treatment of TS. Our results demonstrate tumor control rates and clinical outcomes that parallel those of previous reports using gamma knife radiosurgery; however, long-term follow-up studies are needed. Copyright ? 2009 by the Congress of Neurological Surgeons.
SDGs
Other Subjects
corticosteroid; gabapentin; adolescent; adult; aged; article; cancer control; clinical article; diagnostic imaging; dysesthesia; face pain; female; follow up; gamma knife radiosurgery; headache; human; jaw; male; medical record; neurilemoma; paresthesia; priority journal; radiation dose; radiation necrosis; retrospective study; stereotaxic surgery; surgical technique; trigeminal nerve; tumor volume; weakness; Adolescent; Adult; Aged; Aged, 80 and over; Cranial Nerve Neoplasms; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurilemmoma; Radiosurgery; Retrospective Studies; Treatment Outcome; Trigeminal Nerve Diseases
Type
journal article