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- W2076241253 abstract "Purpose/Objective: FSR offers the potential advantage of divided low dose treatment with the precision of stereotaxy for AN using the Gill-Thomas-Cosman relocatable head frame. FSR is appealing because of radiobiological repair of normal surrounding structures while attempting to maintain efficacy of treatment. Materials/Methods: Described are 310 patients (pts) aged 11 – 88 years (mean 53) with 323 AN ranging in volume from 0.05 – 34.7cc (mean 4.1). 257 AN had maximum diameters <3cms (range 0.3 – 2.8, mean 1.6) and 66 measured 3cms or greater (range 3.0 – 5.8, mean 3.6). Two thousand Centigray (cGy) divided in 4 or 5 fractions was delivered utilizing stereotactic radiosurgery technique. The majority of tumors larger than 3cm have 5 fraction FSR. Progressive enlargement is defined as two consecutive increases in size of the AN as determined by follow-up MRI. Included are twenty-six patients with Neurofibromatosis type 2. Results: Control after FSR is defined as cessation of growth, shrinkage or disappearance of the tumor in the treated field. Clinical follow-up ranged from 1 – 100 mos (mean 33.3). Patients were followed with MRI and hearing tests in 6 month intervals for the first two years and annually thereafter. For the AN less than 3cms, 251 AN (98%) were controlled while 6 (2%) progressively enlarged. Of 141 pts with pure tone audiometry, 20 (14%) improved, 85 (60%) remained stable and 36 (26%) worsened. One elderly pt with uncontrolled hypertension had transient facial weakness, which spontaneously resolved. Of 173 pts, 58 (34%) had improved balance, 107 (62%) stable, and 8 (4%) worsened. For the AN that were 3cms or greater, all 66 AN (100%) were controlled. Of 23 pts with follow-up audiometry, 6 (26%) improved, 9 (39%) were stable and 8 (35%) worsened. Of 55 symptomatic pts, 26 (48%) had improved balance, 25 (45%) were stable and 4 (7%) worsened. Overall, 98% (317 AN) were controlled and 2% (6 AN) showed progressive enlargement. Only 3 (1%) required surgery after treatment with 320 AN (99%) requiring no further therapy. Conclusions: FSR is an effective treatment for pts with AN either less than or greater than 3cms in maximum diameter. Size is not a critical feature in control after FSR. This is especially important since toxicity of surgical removal increases with tumor size. The vast majority of pts after FSR maintain hearing, avoid facial or trigeminal neuropathy and remain in remission years after treatment." @default.
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- W2076241253 date "2003-10-01" @default.
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- W2076241253 title "Fractionated Stereotactic Radiosurgery (FSR) for Acoustic Neuroma (AN) — lack of side effects" @default.
- W2076241253 doi "https://doi.org/10.1016/s0360-3016(03)01206-9" @default.
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