Sorry for the delay, but as promised here is the abstract from the latest and most comprehensive study from Pittburgh, published in 2005.
I have the full article as well, if you are interested please PM me with your e-mail address.
Marianna
Radiosurgery of vestibular schwannomas: summary of
experience in 829 cases
L. DADE LUNSFORD, M.D., AJAY NIRANJAN, M.B.B.S, M.S., JOHN C. FLICKINGER, M.D.,
ANN MAITZ, M.SC., AND DOUGLAS KONDZIOLKA, M.D., F.R.C.S.
Departments of Neurological Surgery and Radiation Oncology, The University of Pittsburgh School of
Medicine; and The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Object. Management options for vestibular schwannomas (VSs) have greatly expanded since the introduction of
stereotactic radiosurgery. Optimal outcomes reflect long-term tumor control, preservation of cranial nerve function,
and retention of quality of life. The authors review their 15-year experience.
Methods. Between 1987 and 2002, some 829 patients with VSs underwent gamma knife surgery (GKS). Dose selection,
imaging, and dose planning techniques evolved between 1987 and 1992 but thereafter remained stable for 10
years. The average tumor volume was 2.5 cm3. The median margin dose to the tumor was 13 Gy (range 10–20 Gy).
No patient sustained significant perioperative morbidity. The average duration of hospital stay was less than 1 day.
Unchanged hearing preservation was possible in 50 to 77% of patients (up to 90% in those with intracanalicular
tumors). Facial neuropathy risks were reduced to less than 1%. Trigeminal symptoms were detected in less than 3%
of patients whose tumors reached the level of the trigeminal nerve. Tumor control rates at 10 years were 97% (no additional
treatment needed).
Conclusions. Superior imaging, multiple isocenter volumetric conformal dose planning, and optimal precision and
dose delivery contributed to the long-term success of GKS, including in those patients in whom initial microsurgery
had failed. Gamma knife surgery provides a low risk, minimally invasive treatment option for patients with newly diagnosed
or residual VS. Cranial nerve preservation and quality of life maintenance are possible in long-term follow up.
