RE: Akustikusneurinom
Die Radiochirurgie (an einem speziellen Linearbeschleuniger) stellt eine Alternative zur Chirurgie beim Akustikusneurinom dar. Es gibt zwar keine direkte vergleichende Studie, aber sog. Phase II Studien weise auf vergleichbare Ergebnisse. Jedes Verfahren hat Vor- und Nachteile, die im Einzelfall zu diskutieren sind. Unter anderem haängt es von der Tumorgröße und –ausdehnung ab.
Anbei ein Beispiel für einen Bericht von einem deutschen Zentrum. Das Gamma-Knife ist ein spezielles Bestrahlungsgerät, welches besonders präzise ist und daher von einigen favorisiert wird. Der Unterschied zu einem guten Beschleuniger ist vermutlich gering.
Acta Neurochir Suppl. 2004;91:75-8
Results of outpatient gamma knife radiosurgery for primary therapy of acoustic neuromas.
Muacevic A, Jess-Hempen A, Tonn JC, Wowra B.
German Gamma Knife Center Munich, Ludwig-Maximilians University, Munich, Germany.
[email protected]
Stereotactic radiosurgery (SRS) has been recognized as a non-invasive alternative to surgery for the treatment of acoustic neuromas. Purpose of the current study was to define the impact of outpatient gamma knife radiosurgery (GKS) for patients with unilateral sporadic acoustic neuromas treated within ten years. Follow-up images were analyzed using tumor volume measurements. 219 patients with sporadic acoustic neuromas were treated by GKS as primary therapy. Patients with NF-2 tumors were excluded. Patients were eligible for GKS up to a size limit of 12.5 cm3. The median follow up time was 6 years after radiosurgery. The local tumor control rate was high (97%). Cranial nerve morbidities were comparably low. 10% of the patients developed hearing loss after radiosurgery and one patient experienced a transient facial neuropathy (0.5%). Transient trigeminal neuropathy developed in 12 patients (5%) and was found to be dependent on the tumor size before treatment. Outpatient gamma knife radiosurgery is a safe and effective treatment method for selected patients with sporadic vestibular schwannomas.
