Vestibular schwannoma (VS), also referred to as acoustic neuroma, is one of the common benign intracranial tumors with rising incidence due to improved and more frequent neuroimaging. These common tumors of the cerebellopontine angle arise from the Schwann cells of vestibulocochlear nerve, and management with main therapeutic modalities of surgery and radiation therapy (RT) may be considered while observation is also an option for selected patients. Intervention may be required for VS although these slow growing tumors may follow an indolent disease course. Decision for management with a given modality should take into account several factors including lesion location, size, and closeness to critical structures, age, symptomatology, patient preferences, and logistical issues. RT has traditionally served as a viable treatment modality for VS management and radiosurgical applications in the forms of single fraction Stereotactic Radiosurgery (SRS) or Fractionated Stereotactic Radiotherapy (FSRT) have been utilized for treatment of patients. Selection of dose and fractionation is critical for safe and effective radiosurgical treatment of VS. Studies of SRS and FSRT for VS management consistently reported high tumor control rates with both modalities. It appears that smallerVS lesions are well suited for single dose SRS while FSRT may serve as an excellent treatment alternative for management of larger VS lesions particularly for improving the toxicity profile of treatment. Herein, we assess the use of single fraction SRS versus FSRT for management of VS in light of the literature with focus on recent trends and future perspectives.
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Published on: Jun 11, 2020 Pages: 62-66
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DOI: 10.17352/2455-2968.000099
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