J Neurol Surg B Skull Base 2016; 77(01): 075-080
DOI: 10.1055/s-0035-1564056
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas

Wenyin Shi
1   Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Varsha Jain
2   Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Hyun Kim
1   Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Colin Champ
3   Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, United States
,
Gaurav Jain
4   Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Christopher Farrell
4   Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
David W. Andrews
4   Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Kevin Judy
4   Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Haisong Liu
1   Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Gregory Artz
5   Department of Otolaryngology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Maria Werner-Wasik
1   Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
James J. Evans
4   Department of Neurological Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

23 March 2015

09 July 2015

Publication Date:
14 September 2015 (online)

Abstract

Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS.

Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8–54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS.

Results The median follow-up time was 43 months (range: 10–75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration.

Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS.