The Role of Radiotherapy in Vestibular Schwannoma's Treatment: Retrospective Trial

OBJECTIVE<br /> This retrospective study, spanning from 2012 to 2022 at Dokuz Eylul University Radiation Oncology Institution, aims to analyze outcomes in vestibular schwannoma (VS) patients undergoing various treatments. METHODS<br /> Thirty-two adult patients (?18 years) who received stereotactic radiosurgery (SRS), stereotactic radiotherapy (SRT), or fractionated radiotherapy (FRT) at DEU and had a minimum follow-up of six months were included. The Koos Grading Scale for VS lesions, Gardner-Robertson Grading for hearing, and House-Brackmann Scale for facial nerve functions were used. Statistical analyses employed SPSS v24, Kaplan-Meier methodology, and the log-rank test. RESULTS<br /> The median age of the patients was 56, predominantly exhibiting Koos 4 lesions (43.8%). The median VS volume was 3.5 cm(3), and the Planned Target Volume (PTV) was 5.4 cm(3). Common fractionation schemes were 5x4.5/5 Gy (46.9%) and 1x12/13 Gy (43.8%). At two years, overall survival (OS) reached 96.9%, with lesion stability in 46.9% and regression in 53.1%. CONCLUSION<br /> This study underscores the importance of considering treatment fractionation, cochlear sparing, and lesion grading to achieve favorable outcomes and effectively manage toxicity in patients with vestibular schwannomas (VS). The Koos score has been identified as a significant factor influencing lesion regression. Further investigation involving a larger patient number is recommended to delineate the factors influencing treatment response.