Monday, September 14, 2009



Dr.Sanjay Chandrasekhar – Senior Consultant Radiation Oncology

Acoustic Neuromas have always been considered ideal targets for radiosurgery.
These tumors generally cause diminished hearing or loss of hearing, giddiness or dizziness, loss of equilibrium or balance and facial nerve paralysis.

Traditionally these tumors have been treated either surgically or with radiation. Surgical removal of these tumors has been associated occasionally with injury to the facial nerve.

Either conventional radiotherapy, Stereotactic radio therapy or single fraction Gamma knife or X-knife radio surgery have been used for patients with Acoustic Neuromas depending on size, symptoms at presentation, cost factor etc.,

Small Acoustic Neuromas are considered ideal targets for stereotactic radiosurgery. Large series of such patients treated with either Gamma Knife or X-knife have been published. The earlier experience with Gamma knife or X- Knife in treating these tumors with a single fraction radio surgery had yielded reasonably good responses and long term tumor control rates.

The incidence of facial nerve injury and diminution of hearing in a sizeable number of patients while using single high dose radio surgery prompted investigators to explore the possibility of using fractionated radio surgery of Acoustic Neuromas.

Fractionated radio surgery has evolved recently with the increased use of the CyberKnife as a potent tool in the management of these benign tumors. The frameless feature of the cyberknife has resulted in bettering patient compliance and comfort. The entire treatment is completed over 3-5 days on an outpatient basis. In addition, the entire treatment is robotically guided increasing the accuracy to a sub millimeter level.

The cyberknife experts worldwide are convinced about the efficacy and safety of the use of fractionated Cyberknife radiosurgery in the treatment of Acosutic Neuromas. The long term tumor control rates and hearing preservation rates have been extremely satisfactory according to them(University of Stanford experience).
You can also read a success story through the following link :