A retrospective cohort study of stereotactic radiosurgery for vestibular schwannomas: Comparison of two age groups (75 years or older vs. 65-74 years).

Background: Treatment outcome data of stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) in patients ≥75 years (late elderly) are lacking. Approximately 39% of patients ≥75 years with VS were reported to experience severe facial palsy after surgical removal. This study compared the treatment outcomes post-SRS for VS between patients ≥75 and 65-74 years (early elderly).
Methods: Of 453 patients who underwent gamma knife SRS for VS, 156 were ≥65 years old. The late and early elderly groups comprised 35 and 121 patients, respectively. The median tumor volume was 4.4 cc, and the median radiation dose was 12.0 Gy.
Results: The median follow-up periods were 37 and 56 months in the late and early elderly groups, respectively. Tumor volume control was observed in 27 (88%) and 95 (83%) patients ( P = 0.78), while additional procedures were required in 2 (6%) and 6 (6%) patients ( P = 1.00) in the late and early elderly groups, respectively. At the 60 ^th and 120 ^th months post-SRS, the cumulative tumor control rates were 87%, 75%, 85%, and 73% ( P = 0.81), while the cumulative clinical control rates were 93% and 87%, 95%, and 89% ( P = 0.80), in the late and early elderly groups, respectively. In the early elderly group, two patients experienced facial pain, and one experienced facial palsy post-SRS; there were no adverse effects in the late elderly group (both P = 1.00).
Conclusion: SRS is effective for VS and beneficial in patients ≥75 years old as it preserves the facial nerve.
Competing Interests: There are no conflicts of interest.
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