{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:42:37Z","timestamp":1789785757844,"version":"4.0.1"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,10]]},"abstract":"\nObject<\/jats:title>\nThe decline in cranial nerve morbidity after radiosurgery for vestibular schwannoma (VS) correlates with dose reduction and other technical changes to this procedure. The effect these changes have had on tumor control has not been well documented.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe authors performed a retrospective review of 293 patients with VSs who underwent radiosurgery between 1990 and 2004 and had a minimum of 24 months of imaging follow-up (90% of the entire series). The median radiation dose to the tumor margin was 13 Gy. Treatment failure was defined as progressive tumor enlargement noted on 2 or more imaging studies. The mean postradiosurgical follow-up was 60.9 \u00b1 32.5 months.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nTumor growth was noted in 15 patients (5%) at a median of 32 months after radiosurgery. Radiographically demonstrated tumor control was 96% at 3 years and 94% at 7 years after radiosurgery. Univariate analysis revealed 2 factors that correlated with failed radiosurgery for VS: an increasing number of isocenters (p = 0.03) and tumor margin radiation doses \u2264 13 Gy (p = 0.02). Multivariate analysis showed that only an increasing number of isocenters correlated with failed VS radiosurgery (hazard ratio 1.1, 95% CI 1.02\u20131.32, p < 0.05). The tumor margin radiation dose (p = 0.22) was not associated with tumor growth after radiosurgery.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nDistortion of stereotactic MR imaging coupled with increased radiosurgical conformality and progressive dose reduction likely caused some VSs to receive less than the prescribed radiation dose to the entire tumor volume.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.3.jns08949","type":"journal-article","created":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T13:51:46Z","timestamp":1241185906000},"page":"840-844","source":"Crossref","is-referenced-by-count":51,"title":["Failure rate of contemporary low-dose radiosurgical technique for vestibular schwannoma Clinical article"],"prefix":"10.3171","volume":"111","author":[{"given":"Bruce E.","family":"Pollock","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Foote","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1110840","series-title":"J Neurosurg","first-page":"1220","article-title":"Comparison of the surgical and follow-up costs associated with microsurgical resection and stereotactic radiosurgery for vestibular schwannoma","volume":"108","author":"Banerjee","year":"2008"},{"issue":"5 Suppl","key":"b2-1110840","series-title":"J Neurosurg","first-page":"445","article-title":"Effect of subpixel magnetic resonance imaging shifts on radiosurgical dosimetry for vestibular 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experience","volume":"58","author":"Pollock","year":"2006"},{"key":"b19-1110840","series-title":"Neurosurgery","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock","year":"2006"},{"key":"b20-1110840","series-title":"Neurosurgery","first-page":"215","article-title":"Outcome analysis of acoustic neuroma management: a comparison of microsurgery and stereotactic radiosurgery","volume":"36","author":"Pollock","year":"1995"},{"issue":"5 Suppl","key":"b21-1110840","series-title":"J Neurosurg","first-page":"588","article-title":"Impact of the model C and Automatic Postioning System on Gamma Knife radiosurgery: an evaluation in vestibular schwannomas","volume":"97","author":"R\u00e9gis","year":"2002"},{"key":"b22-1110840","series-title":"J Neurosurg","first-page":"1091","article-title":"Functional outcome after gamma knife surgery or 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