Abstract 2329
Background
Stereotactic radiosurgery (SRS) is a noninvasive alternative to microsurgery in the management of acoustic neuromas. Single fraction Gamma Knife SRS of acoustic neuromas results in high rates of local control (85-97 %). CyberKnife (CK) Robotic SRS is an alternative technique delivering the same quality SRS but with the benefits of a frameless treatment system allowing for fractionated treatment. The body of evidence in its use for acoustic neuromas is less robust. We present mature outcomes of a large cohort of patients treated with CK at a single institution.
Methods
This study consisted of 120 acoustic neuroma patients treated with CK from Sept 2010 until March 2016. Patients with complete hearing loss were treated with a single 12 Gy fraction (6 Pts). Those with hearing preservation or moderate to large tumors were treated with 18 Gy in 3 fractions (114pts). Follow-up T2 axial MRIs (0.50 mm slice) were analyzed to evaluate rates of tumor control and incidence of pseudo-progression. To obtain volumetric response data, MRI images were contoured on PACs imaging station using Aquarius Net version 4.4.13 by a single radiation oncologist.
Results
Patients range in age from 15 to 91 (mean 58). The median follow up time was 60 months. Mean tumor size was 2.8 cm3 (Range 0.1-30). Progression occurred in 4 patients (local control rate of 97%). Pseudo-progression was seen in 17 cases. For patients with pseudo-progression mean time to the maximum imaged tumor volume post treatment was 5 months (Range of 3 to 12 months) with an average volume increase of 11% (Max 31%). Mean time to subsequent regression to pre-treatment size was 15 months (Range of 10-23) No pseudo-progression led to subsequent local recurrence. There were low rates of late toxicity. One patient who progressed suffered CN VII palsy prior to salvage surgery. All other patients had preserved CNV and CNVII function and there was no case of brain stem necrosis.
Conclusions
Cyberknife offered high rates of durable local control (97 %) for acoustic neuromas with low rates of toxicity. Pseudo-progression was seen in 14% of patients and was not a predictor for treatment failure.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Malone: Honoraria (self): Janssen; Honoraria (self): Astellas; Travel / Accommodation / Expenses: TerSera; Honoraria (self): AstraZeneca; Honoraria (self): AMGEN; Travel / Accommodation / Expenses: Sanofi; Honoraria (self): Abbvie; Honoraria (self): Bayer. All other authors have declared no conflicts of interest.
Resources from the same session
920 - Efficacy of intravenous (IV) NEPA, a fixed NK1/5-HT3 receptor antagonist (RA) combination, for prevention of CINV following cisplatin- and anthracycline cyclophosphamide (AC)-based chemotherapy (CT)
Presenter: Lee Schwartzberg
Session: Poster Display session 1
Resources:
Abstract
5146 - Efficacy of olanzapine combination in prevention of nausea & vomiting in highly emetogenic chemotherapy
Presenter: Smitha Saldanha
Session: Poster Display session 1
Resources:
Abstract
1947 - Patient-reported outcome data during real-world use of NEPA for prevention of chemotherapy-induced nausea and vomiting in high-risk platin-receiving patients - A prospective multicenter trial
Presenter: Meinolf Karthaus
Session: Poster Display session 1
Resources:
Abstract
6163 - A study evaluating steroid induced metabolic syndrome after antiemetic dexamethasone therapy in patients received high emetic risk chemotherapy
Presenter: Hee Jun Kim
Session: Poster Display session 1
Resources:
Abstract
2154 - High incidence of nausea during initial and repeated courses if intravenous chemotherapy in patients receiving guideline consistent antiemetic prophylaxis - a prospective, observational, real world study.
Presenter: Teresa Smit
Session: Poster Display session 1
Resources:
Abstract
1637 - "Randomised controlled trial of Scalp Cooling (SC) for the prevention of Chemotherapy Induced Alopecia (CIA)”
Presenter: Jyoti Bajpai
Session: Poster Display session 1
Resources:
Abstract
5351 - Performance of the ‘4S rule’ to predict short-term outcomes in cancer outpatients with unsuspected pulmonary embolism.
Presenter: David Pesántez Coronel
Session: Poster Display session 1
Resources:
Abstract
1189 - Prevalence of venous thromboembolism based on intensive screening for patients with advanced solid tumor in prospective observational study
Presenter: Shota Omori
Session: Poster Display session 1
Resources:
Abstract
4340 - Short-term outcomes of cancer patients with pulmonary embolism according to the setting (hospital-acquired vs. outpatient) at diagnosis.
Presenter: Diego Muñoz Guglielmetti
Session: Poster Display session 1
Resources:
Abstract
4658 - Patient-reported outcomes associated with switching to rivaroxaban for the treatment of venous thromboembolism (VTE) in patients with active cancer
Presenter: Alexander Cohen
Session: Poster Display session 1
Resources:
Abstract