Acoustic tumors: Viewpoint—stereotactic radiotherapy

Abstract

Despite their benign pathology, acoustic neuromas remain a clinically challenging posterior fossa tumor frequently resulting in hearing loss, tinnitus, vestibular dysfunction, and diminished quality of life. Although advances in microsurgical technique have reduced operative morbidity, a growing number of patients are electing to pursue definitive treatment nonsurgically with stereotactic radiation with outcomes reflecting excellent tumor control and cranial nerve preservation. While stereotactic radiosurgery (SRS) remains the most widely practiced method of stereotactic radiation, an increasing assemblage of institutions have adopted techniques involving fractionation in an effort to improve functional hearing preservation and reduce the morbidity associated with irradiation of large acoustic neuromas. This chapter is devoted to the method of fractionated stereotactic radiotherapy (FSR) for the treatment of acoustic neuromas with a discussion of the radiobiological advantages it provides for preservation of cranial nerve function.​