Which treatment is better for preserving hearing?

[ShoeGalBecky]

I apologize in advance because this subject has been brought up in other posts. I am very confused. I have a small AN (still in measured in mm). I am not a candidate for surgery due to migraines. The hospital I am scheduled to undergo radiotachtic therapy uses LINAC. The doctor basically told me that CK, GK and Linac are the same, just different brand names. However that does not seem to be the case, from what I have read here. My hearing is 100% normal. My only symptoms are extreme bouts of vertigo and a "plugged" feeling in my ear. Which of the radiation treatments is best for preserving hearing? If CK or GK would be better in my situation perhaps I should go to another city for treatment. Since, I have normal hearing right now, I would hate to rush into treatment only to destroy my hearing months or perhaps years before the tumor would. I am really confused. I truly would appreciate any input. Thanks much.

[Lorenzo]

Hi SheogalBecky,
As far as i remember CK has the highest probability of preserving hearing. The three are NOT the same, different machines working in different ways. All use radiation, but that's about where the comparaison stops.
Did you talk to any other radiosrugeon? Maybe that would be sonmething to do. Did you look at the CyberKnife support group forum? The docs there are very helpful, and not just on purely CK questions.
Good luck with your search.
Ciao, Lorenzo

[ppearl214]

Hi Becky,

Lorenzo is certainly correct.... the radio-protocols are not the same.  As with any treatment options, risks involved do include potential hearing loss but overall, my understanding is that CK and GK give best chance of hearing preservation.  I have to agree about asking the docs that volunteer their time on the CK Patient Support Board (http://www.cyberknifesupport.org/forum/).  They can give you specifics and stats re: hearing preservation for all forms of radio-surgery, as they treat AN's with CK and GK (Dr. Medbery still performs both protocols).

In my experience, I had my CK just under a year ago.  At time of treatment, my hearing was just at the bottom of the "normal" range.  6 mos post-treatment, it had diminished just below the "normal" range... 10 mos post-treatment, it's back to what it was at the time of treatment.  Those are my stats and hope that others will chime in with their's so you can get a good sense of where folks that participate on this board stand re: their hearing post treatment.

Phyl

[ppearl214]

Becky,

I just found this response re: Trilogy on the CK Patient Support website. I hope this helps.

Phyl

=====================================\\radsrus
Registered Member


Date Joined Jul 2004
Total Posts : 2838
      Posted 3/16/2007 5:05 AM (GMT -8)     
The accuracy of the Trilogy is closer to 2-3 mm. That may not seem like much (compared to the 0.89 mm accuracy of the Cyberknife) but it is enough to potentially put the critical structures such as the brainstem and cochlea at risk. Furthermore, any of the "stereotactic" accelerator systems are limited in the number of angles from which they can treat. In general, they cannot conform the treatment as closely to the tumor, particularly an irregularly shaped tumor. You are better off with a dedicated stereotactic instrument such Cyberknife or Gamma Knife. There is suggestive evidence that hearing may be better preserved with fractionated treatment on the CK, but that is not fully established by any means.


--------------------------------------------------------------------------------
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org or cmedbery@coxinet.net

Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave.
Oklahoma City, OK 73102
 

[ShoeGalBecky]

Thanks Phyl!
Yes, that would be helpful to know the stats on how others' hearing has been affected post-treatment.
Thank you.

[ppearl214]

Becky,

We posted at the same time Not sure if you saw my last post... it may be helpful.

Phyl

[Windsong]

HI ShoeGalBecky,

Probably I could have posted this link below earlier  as I read it online prepublishing in February, but after reading the posts in this thread answering your question, I am posting it now. It offers numbers for FSR  and also mentions results regarding hearing. I think that FSR is a contender for not only An tumour growth control but also hearing preservation.


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17318817&query_hl=1&itool=pubmed_docsum

I know that many of you will be interested in this.

Cheers,

Windsong

PS. ShoeGalBecky... best wishes sent your way.

Many of you know that I was fortunate in having better hearing post fsr (LINAC) treatment. I was thrilled with the improvement.
Yes, I have lost it since but also some in my other ear.  I have had issues with my hearing for about two decades  due to eustachian tube dysfunction, fluid behind the ear drums and ventiilation tubes during all that time so I don't think my loss now has much to do if anything really with my own fsr treatment. Something else is going on with my ears and that is being checked out.

[elise]

shoegal becky...i was zapped with GK 5 years ago...everything was fine until this past year...the tumour has grown back + ...i think that consideration of the relative  slightness of your  symptoms is essential...when i decided to have it done, i had experienced a great loss of hearing in one ear and serious bouts of vertigo...even tho my tumour was small as well...looking back, i'm not sure whether it wouldn't have been a good idea to take the wait and see position...now that it's back, my options are probably more limited...