Vestibular dose correlates with dizziness after radiosurgery for the treatment of vestibular schwannoma.

Ermiş, Ekin; Anschuetz, Lukas; Leiser, Dominic; Poel, Robert; Raabe, Andreas; Manser, Peter; Aebersold, Daniel M.; Caversaccio, Marco; Mantokoudis, Georgios; Abu-Isa, Janine; Wagner, Franca; Herrmann, Evelyn (2021). Vestibular dose correlates with dizziness after radiosurgery for the treatment of vestibular schwannoma. Radiation oncology, 16(1), p. 61. BioMed Central 10.1186/s13014-021-01793-7

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BACKGROUND

Stereotactic radiosurgery (SRS) has been recognized as a first-line treatment option for small to moderate sized vestibular schwannoma (VS). Our aim is to evaluate the impact of SRS doses and other patient and disease characteristics on vestibular function in patients with VS.

METHODS

Data on VS patients treated with single-fraction SRS to 12 Gy were retrospectively reviewed. No dose constraints were given to the vestibule during optimization in treatment planning. Patient and tumor characteristics, pre- and post-SRS vestibular examination results and patient-reported dizziness were assessed from patient records.

RESULTS

Fifty-three patients were analyzed. Median follow-up was 32 months (range, 6-79). The median minimum, mean and maximum vestibular doses were 2.6 ± 1.6 Gy, 6.7 ± 2.8 Gy, and 11 ± 3.6 Gy, respectively. On univariate analysis, Koos grade (p = 0.04; OR: 3.45; 95% CI 1.01-11.81), tumor volume (median 6.1 cm3; range, 0.8-38; p = 0.01; OR: 4.85; 95% CI 1.43-16.49), presence of pre-SRS dizziness (p = 0.02; OR: 3.98; 95% CI 1.19-13.24) and minimum vestibular dose (p = 0.033; OR: 1.55; 95% CI 1.03-2.32) showed a significant association with patient-reported dizziness. On multivariate analysis, minimum vestibular dose remained significant (p = 0.02; OR: 1.75; 95% CI 1.05-2.89). Patients with improved caloric function had received significantly lower mean (1.5 ± 0.7 Gy, p = 0.01) and maximum doses (4 ± 1.5 Gy, p = 0.01) to the vestibule.

CONCLUSIONS

Our results reveal that 5 Gy and above minimum vestibular doses significantly worsened dizziness. Additionally, mean and maximum doses received by the vestibule were significantly lower in patients who had improved caloric function. Further investigations are needed to determine dose-volume parameters and their effects on vestibular toxicity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology > Medical Radiation Physics
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Ermis, Ekin; Anschütz, Lukas Peter; Leiser, Dominic; Poel, Robert; Raabe, Andreas; Manser, Peter; Aebersold, Daniel; Caversaccio, Marco; Mantokoudis, Georgios; Abu-Isa, Janine; Wagner, Franca and Herrmann, Evelyn

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1748-717X

Publisher:

BioMed Central

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

11 May 2021 15:08

Last Modified:

16 May 2021 03:04

Publisher DOI:

10.1186/s13014-021-01793-7

PubMed ID:

33771181

Uncontrolled Keywords:

Dizziness Radiosurgery Vestibular schwannoma Vestibule

BORIS DOI:

10.48350/155692

URI:

https://boris.unibe.ch/id/eprint/155692

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