Radiation treatments highly effective in halting growth of acoustic neuromas Outpatient therapies need

Radiation treatments highly effective
in halting growth of acoustic neuromas
Outpatient
therapies need
no recovery time
“Patients require no recovery
time from these stereotactic
treatments, and they suffer no
disability or decline in quality
of life,” says Michael Selch,
M.D., professor of radiation
oncology at UCLA. “The thing
that patients worry about the
most — injury to the nerve
that controls motor funtion
in the face — is extremely
uncommon.”
Physicians at UCLA are using the latest stereotactic radiation technology to treat
acoustic neuromas while preserving hearing and exposing patients to as little risk
of nerve damage as possible. In excess of 95 percent of these tumors are successfully
treated using non-invasive, outpatient stereotactic radiation treatments.
An acoustic neuroma, also known as vestibular schwannoma, is a benign tumor
of the auditory nerve. Symptoms include hearing loss, tinnitus, vertigo, facial
numbness and facial weakness. If left untreated, these tumors can grow large
enough to exert pressure on important brain structures.
Radiosurgery and radiotherapy
The advanced Novalis Tx™ linear accelerator enables UCLA’s Department of
Radiation Oncology to offer both stereotactic radiosurgery (SRS) — delivering
a single, very high dose radiation exposure in one session — and stereotactic
radiotherapy (SRT), in which smaller, fractionated doses are given on consecutive
days over the course of multiple weeks.
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In addition to having a highly
experienced team, with
essentially the same personnel
providing stereotactic radiation
and neurosurgery treatments for
approximately 20 years, UCLA
is among the best equipped
center. “Our linear accelerator,
Novalis Tx, has the most
modern features for effectively
immobilizing the patient and
putting the radiation beam
right on the target,” explains
Dr. Selch. “The precision is
extraordinary.”
“This technology, pioneered and
further developed at UCLA,
allows better preservation of
hearing with multiple fractions
of radiation,” explains Antonio
De Salles, M.D., professor of
neurological surgery.
While no treatment for acoustic neuroma can restore hearing that has been lost due
to the tumor’s direct damage to the acoustic nerve, the fractionated approach has
proven to preserve patients’ remaining hearing more reliably than other treatments.
For example, while SRS preserves useful hearing in 70 percent of acoustic neuroma
patients, SRT preserves useful hearing in 90 percent of these patients. For this
reason, UCLA physicians usually perform SRT in patients who still have useful
hearing in the affected ear.
While many centers offer SRS — usually via the Gamma Knife or CyberKnife —
very few centers in Southern California have the equipment needed to offer the
fractionated treatments used in SRT. Unlike the Gamma Knife, Novalis Tx
is a “frameless” procedure that is rapid, non-invasive, and comfortable for patients.
Participating
Physician
Antonio De Salles, M.D., Ph.D.
Professor of Neurosurgery
Michael Selch, M.D.
Professor of Radiation Oncology
Both stereotactic treatments are nearly free of other side effects. Injury to the 7th
nerve, which controls motor function in the face, is extremely rare with stereotactic
radiation treatments, and facial numbness following either treatment is extremely
rare as well.
About the treatment
SRS and SRT are both outpatient procedures and are completely painless; patients
have no sensation of being irradiated and are able to pursue their normal activities
immediately after treatment. The actual administration of the radiation dose takes
only a few minutes. For SRT, treatment is usually given five days a week for about
28 sessions.
Before treatment begins, patients typically undergo both magnetic resonance
imaging (MRI) and computed tomography (CT) studies to determine the exact size,
shape and location of the tumor so it can be precisely targeted. During treatment,
the radiation source passes around the patient’s head at different angles in a series
of arcs. Each individual arc that the radiation source travels gets a very low dose of
radiation, but where the arcs intersect the tissue receives a higher amount of precise
radiation. The patient wears a custom facemask during the treatments to help
maintain proper positioning.
For extremely large tumors that are impinging on brain structures, stereotactic
radiation can be combined with neurosurgery to relieve the pressure and prevent
future tumor growth. The surgeon removes enough of the tumor to alleviate
pressure on the brain while the remaining tumor is treated with radiation. UCLA
has extensive experience with both microneurosurgical treatment and stereotactic
radiotherapy for acoustic neuromas — the optimal choice of therapy is selected for
each patient, based on the tumor size and the associated symptoms.
After treatment, acoustic neuroma patients are followed up to ensure there is no late
tumor growth. Patients are checked with an MRI every six months for the first two
years, then annual MRIs after that.
Contact Information
UCLA Department of
Radiation Oncology
200 UCLA Medical Plaza
Suite B265
Los Angeles, CA 90095-6951
Radiation Oncology
(310) 825-9775
Neurosurgery
(310) 794-1221
Fax: (310) 794-9795
www.radonc.ucla.edu
WWW.UCLAHEALTH.ORG
1-800-UCLA-MD1
(1-800-825-2631)
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