Fractionated radiation therapy in the treatment of stage III and IV cerebello-pontine angle neurinomas: preliminary results in 20 cases.

Abstract

From January 1986 to March 1989, 20 patients with stage III and IV cerebello-pontine angle neurinomas were treated with external fractionated radiation therapy; seven patients had phacomatosis. Indications for radiation therapy were as follows: (a) poor general condition or old age contraindicating surgery, 10 patients; (b) hearing preservation in bilateral neurinomas after contralateral tumor removal, 5 patients; (c) partial resection or high risk of recurrence after subsequent surgery for relapse, 4 patients; (d) non-surgical relapse, 1 patient. Most patients were irradiated with a 9 MV linear accelerator. A 3 to 4-field technique with 5 x 5 cm portals was used. Doses were calculated on a 95% isodose and were given 5 days a week for a mean total dose of 5140 cGy (180 cGy/fraction). Median follow-up from radiation therapy was 30 months (7 to 46); 4 patients died, 2 with progressive disease. Two patients underwent total tumor removal after radiation therapy (1 stable and 1 growing tumor). On the whole, 14 tumors remained stable, 3 decreased in size, and 3 progressed. CT scan or NMR tumor changes consistent with partial tumor necrosis appeared in four cases. Hearing preservation was obtained in 3/5 hearing patients with phacomatosis. When surgery is not indicated or incomplete, fractionated radiation therapy appears to be an effective and well-tolerated treatment for stage III and IV neurinomas. Hearing can be preserved.

• Authors: J P Maire, A Floquet, V Darrouzet, J Guérin, J P Bébéar, M Caudry
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 23 Issue 1 Pg. 147-52 ( 1992) ISSN: 0360-3016 [Print] United States
• PMID: 1572811 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Cerebellar Neoplasms (epidemiology, radiotherapy)
• Cerebellopontine Angle
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neurilemmoma (epidemiology, radiotherapy)
• Neurofibromatosis 1 (epidemiology, radiotherapy)
• Neuroma, Acoustic (epidemiology, radiotherapy)
• Retrospective Studies