Patterns of stereotactic radiotherapy utilization and fractionation for acoustic neuroma in the United States
Baho Sidiqi, Niki Sheth, Anna Lee, Joseph Safdieh MD and David Schreiber
Objective: Stereotactic radiosurgery is a commonly offered modality utilized for the treatment of acoustic neuromas. In this study we sought to analyze the national practice patterns and utilization of GK compared to LINAC based radiosurgery.
Methods: Patients diagnosed with an acoustic neuroma between 2004-2013 and treated with LINAC or GK radiosurgery in 1-5 fractions were identified in the National Cancer Database.
Results: There were 2,705 patients analyzed, of which 2,222 (82.1%) received GK and 483 (17.9%) received LINAC based radiosurgery. Single fraction treatment was observed in 98.8% of GK patients, versus 19.5% of LINAC patients. LINAC based radiosurgery use increased from 3.5-3.7% in 2004- 2005 to 15-26% from 2007-2013. On multivariable logistic regression the use of 3-5 fractions was strongly associated with LINAC based radiosurgery (p<0.001).
Conclusion: GK remains the predominant modality for delivering radiosurgery to acoustic neuroma. LINAC based radiosurgery is being cautiously adopted and often utilizes a hypofractionated approach.
Keywords: acoustic neuroma, vestibular schwannoma, NCDB, radiation, SBRT