Comparative Study of Quality of Life after Treatment by Microsurgery or Fractionated Stereotactic Radiotherapy for Vestibular Schwannoma

Microsurgery (MC) and fractionated stereotactic radiotherapy (FSR) are both treatment modality for stages II and III vestibular schwannoma. There is no standardized approach for the treatment of stages II and III in literature. We have compared the efficacy of these therapies options with a quality of life (QOL) study. In this study, we evaluated the posttreatment QOL of these patients treated by MC or FSR. This is a retrospective review of 113 stages II and III vestibular schwannoma cases treated between 2003 and 2011 in our otoneurosurgery department. QOL was assessed using the Short Form SF-36 scale. Comparison was made between the MC group and the FSR group to evaluate the posttreatment QOL at the end of the follow-up. The response rate was 73% for MC group and 68% for RSF group. There were 37 patients in MC group and 42 in FSR group. The FSR group had significantly better scores on the scale in two categories: physical functioning (representing how diseases might impact normal daily physical activities) and role-physical limitations (representing limitations in working and daily activities due to physical health) but MC group had significantly better score in one dimension (p < 0.001): general health assessment by the patients. Even if MC group had more functional difficulties, it evaluated better global health than RSF group. The RSF group need to be screened for a long time and it seems to be a source of stress.