Stereotactic Radiosurgery for Vestibular Schwannoma - A Case-Based Practice Guide from the Radiosurgery Society.

IF 3.4 3区医学 Q2 ONCOLOGY Practical Radiation Oncology Pub Date : 2025-02-03 DOI:10.1016/j.prro.2025.01.010

Felix Ehret, Archis R Bhandarkar, Michael Chisam, Victor Goulenko, Ritesh Kumar, Fatemeh Fekrmandi, Karin A Skalina, John Kresl, Simon S Lo, Iris C Gibbs, Scott G Soltys, Jason P Sheehan, Christoph Fürweger, Ben J Slotman, Helen A Shih, Samuel T Chao

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引用次数: 0

Abstract

Purpose: Vestibular schwannomas (VS) are the most common benign intracranial nerve sheath tumors. Surgery and radiotherapy - particularly stereotactic radiosurgery (SRS) - are the primary treatment options. SRS is the dominant treatment for small- and medium-sized VS and selected larger tumors due to its excellent local control rates and favorable safety profile compared to surgery. However, careful treatment planning is essential, taking into account patient preferences, tumor location and size, symptoms, and anticipated treatment-related toxicity.

Methods and materials: Four clinical VS scenarios have been selected to illustrate the use of SRS, including a unilateral, small intracanalicular VS, a large VS with cystic components, reirradiation with SRS after local tumor recurrence, and bilateral VS in the setting of neurofibromatosis type 2-related schwannomatosis.

Results: SRS is an effective and safe treatment modality for the majority of VS cases, requiring careful treatment planning and a thorough understanding of potential limitations and challenges.

Conclusions: This case-based practice guide aims to provide a concise overview of the treatment of VS with SRS. We present and discuss four different clinical scenarios of VS to illustrate the pitfalls and best practice recommendations.

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.