Stereotactic Radiosurgery for Trigeminal Schwannoma: A Clinical Retrospective Study in 52 Cases
- 26 March 2013
- journal article
- Published by S. Karger AG in Stereotactic and Functional Neurosurgery
- Vol. 91 (4), 236-242
- https://doi.org/10.1159/000345258
Abstract
To evaluate the radiological and clinical outcomes in a series of patients in whom stereotactic radiosurgery (SRS) was used to treat trigeminal schwannomas. The records of 52 patients who underwent SRS for trigeminal schwannoma were reviewed using a retrospective study. The median patient age was 47.1 years (range, 18-77); 20 patients (38.5%) had undergone prior tumor resection and 32 (61.5%) underwent radiosurgery on the basis of imaging diagnosis only. The most frequent presenting symptoms were facial numbness (29 patients), jaw weakness (11 patients), facial pain (10 patients) and diplopia (4 patients). Fifty-two cases with solid tumors were mainly solid in 44 cases (84.6%), mostly cystic in 2 cases (3.8%), and cystic and solid mixed in 6 cases (11.5%). Two cases of mostly cystic tumor first underwent stereotactic cystic fluid aspiration and intracavitary irradiation, and then had MRI localization scan again for gamma knife treatment. The mean tumor volume was 7.2 ml (range, 0.5-38.2). The mean prescription radiation dose was 13.9 Gy (range, 11-17), and the mean prescription isodose configuration was 47.9%. At a mean follow-up of 61 months (range, 12-156), neurological symptoms or signs improved in 35 patients (67.3%), 14 patients (26.9%) had a stable lesion, and worsening of the disease occurred in 2 patients (3.8%). On imaging, the schwannomas almost disappeared in 8 (15.4%), shrank in 32 (61.5%), remained stable in 5 (9.6%), and increased in size in 7 patients (13.5%). Tumor growth control was achieved in 45 (86.5%) of the 52 patients. SRS is an effective and minimally invasive management option for patients with residual or newly diagnosed trigeminal schwannomas. The use of SRS to treat trigeminal schwannomas resulted in good tumor control and functional improvement.This publication has 19 references indexed in Scilit:
- Trigeminal schwannomas: experience with 57 cases and a review of the literatureNeurosurgical Review, 2010
- Gamma Knife surgery and trigeminal schwannoma: is it possible to preserve cranial nerve function?Journal of Neurosurgery, 2007
- Gamma-knife radiosurgery in the treatment of trigeminal schwannomasActa Neurochirurgica, 2007
- Surgical treatment of trigeminal schwannomasNeurosurgical Review, 2007
- Gamma Knife surgery for trigeminal schwannomaJournal of Neurosurgery, 2007
- Trigeminal schwannomas: results of Gamma Knife surgery in 37 casesJournal of Neurosurgery, 2007
- Long-term results of Leksell gamma knife surgery for trigeminal schwannomasJournal of Neurosurgery, 2005
- Gamma knife radiosurgery for trigeminal schwannomasSurgical Neurology, 2004
- Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve functionJournal of Neurosurgery, 2002
- Stereotactic Radiosurgery for Trigeminal SchwannomasNeurosurgery, 1999