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Gamma knife radiosurgery for trigeminal schwannoma: a 20-year experience with long-term treatment outcome

  • Clinical Study
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Abstract

Purpose

This study evaluated the long-term tumor control rate (TCR) and symptomatic outcomes of patients treated with gamma knife radiosurgery (GKRS) for trigeminal schwannomas (TSs).

Methods

Thirty-two patients with TS who underwent GKRS between January 1994 and January 2013 with at least 2 years of follow-up were enrolled in the study. Clinical charts and surgical records were retrospectively reviewed to evaluate factors affecting TCR and symptomatic outcomes. The median patient age was 57.5 years (max = 81, interquartile range [IQR] = 51–67), and the median tumor volume was 3.55 cm3 (max = 25.2 cm3, IQR = 2.0–6.2 cm3). The median marginal and maximum doses were 13.0 Gy (max = 18.0 Gy, IQR = 12.5–15 Gy) and 23.8 Gy (max = 35 Gy, IQR = 21.7–25.0 Gy), respectively.

Results

At a median follow-up of 90.5 months (max = 281 months, IQR = 49–139.75 months), the actuarial 3-, 5-, and 10-year TCR were 93.8, 86.2, and 80.8%, respectively. Our data and multivariate analysis indicated that the target volume was the only significant factor determining TCR and that larger tumors (> 5 cm3) were more likely to progress (p = 0.011). Cystic tumors had a higher incidence of transient enlargement and temporary symptom change compared to those in solid tumors. An unfavorable outcome of symptoms was observed in five patients (15.6%). Complications were observed in two patients (6.25%), including hydrocephalus and radio-induced trigeminal neuropathy, respectively.

Conclusions

GKRS can be a safe and effective treatment modality for TS with long-term follow-up, especially for small tumors. An extended period of follow-up observation is required to conclude the clinical response to GKRS.

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Abbreviations

GKRS:

Gamma knife radiosurgery

IQR:

Inter-quartile range

MR:

Magnetic resonance

TCR:

Tumor control rate

TS:

Trigeminal schwannoma

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There is no personal financial or institutional interest in any of the drugs, materials, or devices described in this article.

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Authors and Affiliations

  1. Department of Neurosurgery, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea

    Jiwook Ryu, Sung Ho Lee, Seok Keun Choi & Young Jin Lim

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  1. Jiwook Ryu
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  2. Sung Ho Lee
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  3. Seok Keun Choi
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Correspondence to Seok Keun Choi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ryu, J., Lee, S.H., Choi, S.K. et al. Gamma knife radiosurgery for trigeminal schwannoma: a 20-year experience with long-term treatment outcome. J Neurooncol 140, 89–97 (2018). https://doi.org/10.1007/s11060-018-2934-1

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  • DOI: https://doi.org/10.1007/s11060-018-2934-1

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