• Geovanne Pedro Mauro, Leila Maria Da Róz, GicoVinicius de CarvalhoVCDepartment of Radiation Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Medical School of Sao Paulo University, Sao Paulo, SP, Brazil., Eduardo Weltman, Evandro César de Souza, Eberval Gadelha Figueiredo, and Manoel Jacobsen Teixeira.
• Department of Radiology and Oncology - Discipline of Radiotherapy- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. Electronic address: geovanne95@gmail.com.
• World Neurosurg. 2023 Nov 1; 179: e416e420e416-e420.

BackgroundThe use of radiotherapy (RT) for the treatment of vestibulocochlear schwannomas is standard in patients with type 2 neurofibromatosis (NF2). In the general population, fractionated RT (FRT) can achieve good results compared to single-dose radiosurgery (SRS). We aimed to assess whether this is true for NF2 patients as well.MethodsThis retrospective cohort study included 34 patients and 54 lesions treated between 2010 and 2023 in a single university hospital.ResultsThirty-four patient charts were assessed. The median follow-up was 62.6 months (range, 7.1-135.8 months). Lesion size (median larger diameter, 2.5 cm) was correlated with the use of FRT (P > 0.001). Younger age also was correlated with FRT (P = 0.006). Median overall survival and progression-free survival (PFS) were not reached. The overall control rate was 76.5%, and the mean PFS was 49.8 months, compared with . 90.5% and 57.2 months, respectively, for SRS and 66.7% and 44.9 months, respectively, for FRT. There were no differences between the 2 groups in hearing loss, tinnitus, and facial palsy.ConclusionsIn the NF2 population, FRT may yield worse control rates than SRS. Whenever possible, it is preferable to not fractionate treatment for these patients. Nevertheless, the FRT results were still good. More and larger prospective trials are warranted.Copyright © 2023 Elsevier Inc. All rights reserved.

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