How do you approach conventionally fractionated radiotherapy for treatment of an acoustic neuroma?
What do you utilize for patient immobilization and what are your PTV margins? What MRI sequences do you favor for target delineation?
Answer from: Radiation Oncologist at Academic Institution
With 12 Gy single-fraction radiosurgery producing excellent tumor control, low complication rate, and good hearing preservation, we have rarely been using conventional fractionated radiotherapy for acoustic neuroma. If one uses conventional fractionated radiotherapy, the PTV margins will depend on t...
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Radiation Oncologist at Meadowview Regional Medical Center Single fraction is the best and safest.
Answer from: Radiation Oncologist at Community Practice
For acoustic neuroma/vestibular schwannoma, single fraction SRS is typically used with excellent local control, and good hearing preservation.But in larger tumors, fractionated radiation therapy can be used. University of Heidelberg published on 57.6 Gy in 32 fractions (Combs et al., IJROBP 2005). T...
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Radiation Oncologist at Kaiser Permanente What constraints do you use for CN VII & V?
Radiation Oncologist at University of Missouri at Columbia, Ellis Fischel Cancer Cener When using fractionated RT, they are often large t...
Answer from: Radiation Oncologist at Academic Institution
I used to favour fractionated radiation therapy to 45-50 Gy for acoustics with serviceable hearing based on some excellent articles from Thomas Jefferson, such as Champ C et al, Neurosurgery 2013. But then the single fraction radio surgery data came out with good hearing preservation rates with the ...
Single fraction is the best and safest.