Mihriban Erdogan Kocak, Adem Sengul, Ali Olmezoglu, Kemal Ekici, Ozgur Seseogullari.
Fractionated stereotactic radiosurgery for vestibular schwannomas using cyberknife: A single institution experience.
J Pak Med Assoc Jan ;66(9):1089-93.

Objective: To assess tumour control, hearing preservation status, and complication ratio after fractionated stereotactic radiosurgery/radiotherapy by using CyberKnife device in patients with vestibular schwannomas. Methods: This retrospective study was conducted at Izmir Ataturk Research and Tranining Hospital, Turkey, and comprised data of vestibular schwannomas patients treated with stereotactic radiosurgery/radiotherapy from March 2010 to December 2013. The patients were subjected to a dose ranging from 12 to 30Gy using CyberKnife system with an average of three fractions. SPSS 17 was used for data analysis. Paired t-test and Pearson's chi-square test were used to compare clinical parameters between groups. P<0.05 was considered significant. Results: Of the 41 patients, 26(63.4%) were women and 15(36.6%) were men. The median follow-up duration after stereotactic radiosurgery/radiotherapy was 25 months (interquartile range: 9-44 months). Radiographic control evaluation ratio was 95.7% with a median follow-up of 3 years (IQR: 18.5 months). Results of 23(56%) patients showed stabile response, 17(42%) regression response and 1(2%) progression response. There were no statistically significant changes between pre- and post-stereotactic radiosurgery/radiotherapy symptoms (p>0.05). One (2.4%) patient reported new onset facial paresis. Conclusion: Stereotactic radiosurgery/radiotherapy treatment of vestibular schwannomas resulted in a good ratio of tumour control. Hearing preservation status and ratios of toxicity were comparable to published literature.

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