| Early Experience of Fractionated Frameless Stereotactic Radiosurgery Using CyberKnife for Vestibular Schwannomas |
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Jong-Won Yoon, Kyung-Bum Park, Hojin Jeong, Dong-Ho Kang, Chul-Hee Lee, Jin-Myung Jung |
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Department of Neurosurgery, Radiation Oncology, School of Medicine, Gyeongsang National University, Jinju, Korea |
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| Abstract |
Purpose
The CyberKnife is a robotic radiosurgery system that enables real-time tumor tracking during stereotactic radiosurgery.
This study aimed to evaluate the clinical efficacy of CyberKnife for treating small- to medium-sized vestibular schwannomas.
Methods
We retrospectively reviewed the medical records and follow-up images for 21 patients that received CyberKnife radiosurgery for vestibular schwannomas. The mean tumor volume was 4.1mL (range : 0.16-16.9mL). The prescribed dose was 18.0
Gy at the median 81.5±2.3% isodose line with respect to the maximum dose, and treatments were divided into 3 fractions. Patients were followed for more than 1 year, with a mean clinical follow-up duration of 21.6 months.
Results
During the follow-up period, 17 of the 21 patients (81.0%) showed tumor regression and 4 patients (19.0%) showed
no further progression, which indicated a 100% response to tumor treatment. Among the 15 patients with preserved hearing prior treatment, 1 showed hearing deterioration after treatment. Therefore, we observed a hearing preservation rate of 93.3%. No
patient showed facial nerve palsy or trigeminal neuropathy during the follow-up period.
Conclusions
On the basis of our findings, we conclude that CyberKnife-based radiosurgery is an effective management strategy
for small- to medium-sized vestibular schwannomas, in terms of both tumor control and prevention of neurological complications. However, our study was limited by its small cohort size and short follow-up duration. Longer and more extensive studies
are needed to further clarify the clinical efficacy of the CyberKknife system for vestibular schwannoma. |
| Key Words:
CyberKnife radiosurgery, Stereotactic radiosurgery, Dose fractionation, Vestibular schwannoma. |
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