FSRT Stats

[Dealy]

In case anyone is interested I went through my notebook and found the study done in Germany on 106 Patients using FSRT from November 1989 to April 2004. This article compares FSRT to a single dose also of radiotherapy. In a nutshell there were 13 with 1CM and less-48 wth 2CM or less-30 with 3CM or less and 13 with 4CM or less and 2 with 4CM or More. Tumor control; at 3 yearto 5 years was not affected by tumor size-age or NF2. 98% hearing preservation was achieved in those who had serviceable hearing at 2 and 5 years and 64% for those in the same time frame with NF2. The median follow-up time was 48.5 months. In all the article concluded that a total of 101 patients achieved tumor control an goes on to say that single dose RT is restricted to small and medium tumors. Damage rates are dependent on dose applied and of course size of AN. Doses exceeding 13GY were associated with high risk of cranial nerve damage. This article is very lengthy but very informative. I tried to highlight the basics. Also realize that I am not pushing FSR over surgery-cyberknife- or GammaKnife. Due to the length of this article-if anyone would be interested in reading this for themselves to make an informed decision- I have this article downloaded on another site. Please-if interested e-mail me and I will direct you to the appropriate site.Of course I concluded after a 3 month research that FSR was appropriate for me-but I also realize like I said before that is up to the individual to decide. I figure the more you know the better choices you can make. have a good day and evening. Ron

[tony]

Interesting - two bits are unclear to me
FSR vs FSRT - same thing or different ?
Also the sizes seem to be going up
2 yrs ago 2.5 cms was considered (by most) to be top end
limit for any radiation (Noren excepted)
Then it moved to 3.0 ish - depending where it is
Now we see 4.0 cms and over is possible - in this respect FSR (T)
is a bit more flexible than gamma
Finally while the NF2 stats are not wonderfull - the comparason
with gamma is a little unfair since the gamma stats are all
2.5cms or less. Despite what it may say - when you get to 3.0 cms or 4.0cms
and over, hearing preservation rates are poor - or there simply
is no hearing left to preserve
Interesting
Best regards
Tony

[Dealy]

Tony- The exact title of the article is: Management of Acoustic Neuromas with Fractionated Stereotactic Radiotherapy (FSRT). In other words- FSRT and FSR are the same thing. I was told at JHH that they would not treat above a 3.0CM. However they used this protocol for treatment and sited this study. Windsong I believe alluded to this same study in one of her posts some time back. It is now using the Linac on a 25 session treatment phase. I agree that anything over 3.0CM is risky. However we do have one person on this site that was treated with above a 3,0 CM-so we know it is done. My computer is unable to download this article-or I would to this site. I had my brother-in-law download to another site some time back. It must come down to the specific Institution and their particular protocol used. Depends I guess if you want to take the risk with a larger tumor-but the option is available. They never mentioned the real downsides-but you have to know their were some. Ron. P.S. Was notified yesterday by JHH that the reason I sound like a foghorn to myself-I have nasal congestion-said it showed up on my brain MRI. I had asked my local ENT to check-but I guess he just ignored me. Anyway-I thought it was something to do with the radiation. JHH said use a de-congestion to try to clear up. Good day-Ron

[tony]

Good answer - the old reason for keeping below 3 ish was due to complications
where the tumour expands as a result of radiation - usually about 6-18mths post treatment - it depends a bit where it is as to how risky this is
4 cms and against the brainstem is usually a no no
- it can create a compression issue - where you dont want one
Larger tumours are a bit more suseptable in this respect
Sometimes they give decadron or similar to reduce the swelling effect
Usually with FSR type treatments the swelling is less likely
and smaller tumours create less issues simply because they are smaller
I think medical science has advanced quite recently here
hence they are willing and able to tackle the larger ones
best regards
tony