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• 5 year tumor control rate of 93%
• 7% tumor recurrence rate
• Hearing preservation rate of 68%
• 2% of the patients developed facial numbness

To read more about this study, please click on this link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&listuids=16094154&queryhl=24&itool=pubmed_docsum

Complications Following Stereotactic Radiosurgery

The rate of complications following stereotactic radiosurgery continues to decline with advances in technology, dose flexibility, and precision of radiation delivery. Some complications commonly associated with stereotactic radiosurgery are facial nerve neuropathy and trigeminal nerve neuropathy. The rates of these complications currently are estimated to occur in up to 3% of patients.

Vestibular dysfunction is estimated to occur in up to 50% of patients following stereotactic radiosurgery. Another potential problem of great significance, though its incidence is not well known yet, is the development of a secondary malignancy due to radiation exposure. It is, therefore, very important for patients to be carefully followed by their health care provider following radiosurgery in order to identify any significant delayed complications that may develop even several years after radiosurgery.

Newer studies with low-dose stereotactic radiosurgery have shown improved results for facial nerve complications, hearing preservation rates of 65%, and no reports of trigeminal nerve complications. Long-term follow-up of patients, however, is necessary to confirm these observations.

There are indications that facial or trigeminal nerve injury following radiosurgery may be increased by factors such as:

• Age of the patient - patients less than 65 years of age are more likely to experience facial and/or trigeminal nerve injury following stereotactic radiosurgery
• High doses of radiation - estimates are that at doses of 16 Gy or higher, 29% of patients experienced facial palsy and 44% of patients experienced symptoms of trigeminal nerve dysfunction. With doses less than 16 Gy, 9.5 % of patients experienced facial palsy while 15.5% of patients experienced trigeminal nerve dysfunction.
• Tumor size of 2 cm or larger
• Prior surgical resection

The risk for developing a secondary malignancy is thought to be approximately 1% at 10 years after stereotactic radiosurgery. These radiation-induced tumors tend to be more aggressive than non-radiation induced tumors and carry a very poor prognosis. This is of particular importance for young people considering stereotactic radiosurgery.

In summary, the advantages of stereotactic radiosurgery include:

• It is less expensive than conventional acoustic neuroma surgery
• Hospital stay following stereotactic radiosurgery is shorter than following conventional surgery
• Entire treatment is completed in one session under local anesthesia with same day discharge
• There are fewer complications and problems immediately following stereotactic radiosurgery resulting in a better quality of life
• Similar rates of hearing preservation and facial nerve injury (with lower dose radiation) as conventional acoustic neuroma surgery
• Patients can usually go back to work the day after treatment

Disadvantages of stereotactic radiosurgery include:

• Costs are higher in the long term since follow-up with periodic imaging studies is critical in post-treatment care and 5% of patients must undergo salvage surgery for tumors that begin to grow again after treatment has been completed