2025 Poster Presentations
P462: ASSESSING PATIENT OUTCOMES OF VESTIBULAR SCHWANNOMA PATIENTS FOLLOWING LINEAR ACCELERATOR STEREOTACTIC RADIOTHERAPY
Hariteja Ramapuram1; Yifei Sun1; Travis Atchley2; Erika Walsh3; John Fiveash4; Philip Schmalz2; Winfield Fischer2; Dagoberto Estevez-Ordonez2; 1Heersink School of Medicine, University of Alabama, Birmingham; 2Department of Neurosurgery, University of Alabama at Birmingham, Alabama; 3Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama; 4Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama
Background: Vestibular schwannomas (VS) are the most common tumors of the cerebellopontine angle. Intensity-modulated radiotherapy (IMRT) using Linear Accelerator (LINAC) has been shown to have favorable outcomes with patients by achieving a good tumor control rate. However, there is limited data on long-term outcomes and safety of LINAC for treatment of VS.
Objective: To characterize patient outcomes of those who LINAC for VS.
Methods: We retrospectively reviewed adult patients with vestibular schwannomas who underwent LINAC stereotactic radiotherapy from 2013 to 2022. Patient outcomes were assessed using qualitative variables such as hearing loss, tinnitus, cranial nerve deficits, and further outcomes.
Results: In total, 41 patients met the inclusion criteria. The median age was 63 years [Interquartile range (IQR) 54-73]. Thirty-six (88%) of the patients were white. The median time to follow-up was 48 months (IQR 26-65). Median tumor volume at presentation was 974 mm3 (IQR 255 – 2587). Median volume at latest follow up was 945 mm3 (IQR 354 – 3085). Median change in tumor size was -29 mm3. Three patients (7.3%) had CN V deficits and 12% had CN VII deficits at latest follow-up. Of the cohort, 10 (24.4%) of patients had full audiology reports before and after LINAC. Four patients had serviceable hearing before LINAC, and 3 patients had serviceable hearing after LINAC. At latest follow-up, 9.8% of patients had hydrocephalus, 22% had gait problems, 4.9% had hypoesthesia, 12% had dysesthesia, 24% had vertigo, and 37% had other balance disorders.
Conclusions: IMRT is a safe method of treatment for VS that presents similar outcomes as other methods of SRS. Future studies should seek to validate outcomes in larger cohorts.