Küchler Maike, El Shafie Rami A, Adeberg Sebastian, Herfarth Klaus, König Laila, Lang Kristin, Hörner-Rieber Juliane, Plinkert Peter Karl, Wick Wolfgang, Sahm Felix, Sprengel Simon David, Debus Jürgen, Bernhardt Denise
Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany.
Department of Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
Cancers (Basel). 2022 Apr 10;14(8):1916. doi: 10.3390/cancers14081916.
To evaluate differences in local tumor control (LC), symptoms and quality of life (QOL) of 261 patients with VS after stereotactic radiosurgery/hypofractionated stereotactic radiotherapy (SRS/HFSRT) vs. fractionated radiotherapy (FRT) vs. fractionated proton therapy (FPT) were studied.
For SRS/HFSRT ( = 149), the median fraction dose applied was 12 Gy. For FRT ( = 87) and FPT ( = 25), the median cumulative doses applied were 57.6 Gy and 54 Gy (RBE), respectively. FRT and FPT used single median doses of 1.8 Gy/Gy (RBE). Median follow-up was 38 months. We investigated dosimetry for organs at risk and analyzed toxicity and QOL by sending out a questionnaire.
LC was 99.5% at 12 months after RT with no statistical difference between treatment groups ( = 0.19). LC was significantly lower in NF2 patients ( = 0.004) and in patients with higher tumor extension grade ( = 0.039). The hearing preservation rate was 97% at 12 months after RT with no statistical difference between treatment groups (p = 0.31). Facial and trigeminal nerve affection after RT occurred as mild symptoms with highest toxicity rate in FPT patients.
SRS/HFSRT, FRT and FPT for VS show similar overall clinical and functional outcomes. Cranial nerve impairment rates vary, potentially due to selection bias with larger VS in the FRT and FPT group.
为评估261例前庭神经鞘瘤（VS）患者在立体定向放射外科/低分割立体定向放射治疗（SRS/HFSRT）、常规分割放射治疗（FRT）和常规分割质子治疗（FPT）后局部肿瘤控制（LC）、症状及生活质量（QOL）的差异。
对于SRS/HFSRT组（n = 149），应用的中位分次剂量为12 Gy。对于FRT组（n = 87）和FPT组（n = 25），应用的中位累积剂量分别为57.6 Gy和54 Gy（相对生物效应）。FRT和FPT采用的单次中位剂量为1.8 Gy/Gy（相对生物效应）。中位随访时间为38个月。我们研究了危及器官的剂量学，并通过发放问卷分析毒性和生活质量。
放疗后12个月时LC为99.5%，各治疗组之间无统计学差异（P = 0.19）。NF2患者的LC显著较低（P = 0.004），肿瘤扩展分级较高的患者LC也显著较低（P = 0.039）。放疗后12个月时听力保留率为97%，各治疗组之间无统计学差异（P = 0.31）。放疗后面部和三叉神经损伤表现为轻度症状，FPT组患者的毒性发生率最高。
VS的SRS/HFSRT、FRT和FPT显示出相似的总体临床和功能结局。颅神经损伤率有所不同，可能是由于FRT和FPT组中VS较大存在选择偏倚。
