Nonvestibular schwannoma

Abstract

CyberKnife radiosurgery has been used to treat nonvestibular schwannomas. There are debates, however, regarding its safety and limitations for microsurgery, radiosurgery, and combined microsurgery and radiosurgery. This chapter evaluates the risk and potential benefits of CyberKnife radiosurgery for nonvestibular schwannomas. We retrospectively reviewed recent studies regarding nonvestibular schwannomas treatment and compared the local tumor control rate, morbidity, and clinical outcome of patients from different approaches, included microsurgery, radiosurgery, and combined microsurgery and radiosurgery. Given the encouraging local tumor control rates, low complication rates, and promising multisession results from recent CyberKnife radiosurgery studies, CyberKnife radiosurgery is no longer just an adjunct therapy for surgery, but is also a primary therapy for select patients. Treatment strategies are evolving with increased focus on reducing treatment-related complications and improving functional outcomes. Further studies are necessary to establish the optimal treatment dose and fractionation protocol.