Non surgical Treatment of Vestibular Schwannoma

Abstract Introduction and objectives To evaluate the results of local control and complications in the treatment of vestibular schwannoma treated with radiation. Methods A retrospective study of 194 patients diagnosed with vestibular schwannoma, treated consecutively with radiation (either stereotactic radiosurgery or fractionated radiotherapy) from 1997 to 2012. We analyse the local control of tumours, as well as secondary complications to treatment with radiation. Results A total of 132 (68%) tumours, 68% are grade I – II tumours of the Koos classification, 40 (19%) are grade III, and 22 (13%) are grade IV. The tumours associated with neurofibromatosis (NF2) are 3.6% (6 tumours in 4 patients). The tumour control for the overall series is 97% at 5 years, with a median follow-up of 80.4 months. For large tumours the local control is 91% at 5 years. Free survival of chronic complications is 89% at 5 years. Additionally, 50 tumours were subjected to regular follow-up with MRI without treatment, and 28 (58%) did not experience tumour growth. Conclusions Radiation and follow-up with MRI are alternatives to surgery in the treatment of vestibular schwannoma, with a low level of complications in a multidisciplinary approach.