Marya Hameed, Sumera Mahar, Naveed Ahmed, Tariq Mahmood


Introduction: Vestibular Schwannomas causes significant morbidity and quality of life can be effected in major way if not promptly managed. There are various therapeutic options available to cure the disease but cyber knife stereotactic radiosurgery is one of leading therapeutic option to manage vestibular schwannomas with minimal to no complications.

Objective: Use of fractionated stereotactic radiosurgery / radiotherapy, specifically cyber knife device in patients with vestibular schwannomas to evaluate tumor control, hearing preservation status and complication ratios.

Methods:  Data was collected comprising of patients with vestibular schwannomas who have been treated with stereotactic radiosurgery/radiotherapy from Dec 2018 to April 2021 at Jinnah postgraduate medical center Karachi. The methods consisted of a prospective study in which the patients were subjected to a dose ranging from 12 to 18 Gy with an average of   three fractions by using cyber knife system. P<0.05 was taken into significant consideration.

Results: 130(56.52%) were women and 100(43.47%) were men, among 230 cases. After stereotactic radiosurgery/radiotherapy the median follow-up duration was 24 months (interquartile range: 10-42 months). With the median follow-up of three years the radiographic control evaluation ratio was 95.7% (IQR: 18.5 months). Among 230 patients, results of 129(56%) patients showed stabile response, 98(42%) showed improving response and three (1.3%) showed worsening response. However there were no statistically significant changes between pre and post treatment symptoms (p>0.05). New onset facial paresis was noted in two (1%) patients.

Conclusion: The outcome of treatment of vestibular schwannomas by using stereotactic radiosurgery resulted in good ratio of tumor control. Ratios of toxicity and hearing preservation status were approximate to the published literature.

Keywords: vestibular schwannomas, cyber knife, stereotactic radiosurgery/radiotherapy.

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