{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:14:25Z","timestamp":1768997665845,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T00:00:00Z","timestamp":1649548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: To evaluate differences in local tumor control (LC), symptoms and quality of life (QOL) of 261 patients with VS after stereotactic radiosurgery\/hypofractionated stereotactic radiotherapy (SRS\/HFSRT) vs. fractionated radiotherapy (FRT) vs. fractionated proton therapy (FPT) were studied. Methods: For SRS\/HFSRT (n = 149), the median fraction dose applied was 12 Gy. For FRT (n = 87) and FPT (n = 25), the median cumulative doses applied were 57.6 Gy and 54 Gy (RBE), respectively. FRT and FPT used single median doses of 1.8 Gy\/Gy (RBE). Median follow-up was 38 months. We investigated dosimetry for organs at risk and analyzed toxicity and QOL by sending out a questionnaire. Results: LC was 99.5% at 12 months after RT with no statistical difference between treatment groups (p = 0.19). LC was significantly lower in NF2 patients (p = 0.004) and in patients with higher tumor extension grade (p = 0.039). The hearing preservation rate was 97% at 12 months after RT with no statistical difference between treatment groups (p = 0.31). Facial and trigeminal nerve affection after RT occurred as mild symptoms with highest toxicity rate in FPT patients. Conclusion: SRS\/HFSRT, FRT and FPT for VS show similar overall clinical and functional outcomes. Cranial nerve impairment rates vary, potentially due to selection bias with larger VS in the FRT and FPT group.<\/jats:p>","DOI":"10.3390\/cancers14081916","type":"journal-article","created":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T06:02:54Z","timestamp":1649570574000},"page":"1916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcome after Radiotherapy for Vestibular Schwannomas (VS)\u2014Differences in Tumor Control, Symptoms and Quality of Life after Radiotherapy with Photon versus Proton Therapy"],"prefix":"10.3390","volume":"14","author":[{"given":"Maike","family":"K\u00fcchler","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami A.","family":"El Shafie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, University Medical Center G\u00f6ttingen, Robert-Koch-Stra\u00dfe 40, 37075 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8463-514X","authenticated-orcid":false,"given":"Sebastian","family":"Adeberg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Deutsches Konsortium f\u00fcr Translationale Krebsforschung (DKTK), Partner Site Heidelberg, INF 280, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), INF 280, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Herfarth","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"},{"name":"Heidelberg Ion Beam Therapy Center (HIT), INF 450, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laila","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliane","family":"H\u00f6rner-Rieber","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"},{"name":"Department of Neurology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Karl","family":"Plinkert","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Wick","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Sahm","sequence":"additional","affiliation":[{"name":"Deutsches Konsortium f\u00fcr Translationale Krebsforschung (DKTK), Partner Site Heidelberg, INF 280, 69120 Heidelberg, Germany"},{"name":"Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, INF 224, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon David","family":"Sprengel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Deutsches Konsortium f\u00fcr Translationale Krebsforschung (DKTK), Partner Site Heidelberg, INF 280, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), INF 400, 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), INF 280, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), INF 460, 69120 Heidelberg, Germany"},{"name":"Heidelberg Ion Beam Therapy Center (HIT), INF 450, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Bernhardt","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), 80333 Munich, Germany"},{"name":"Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Ingolst\u00e4dter Landstra\u00dfe 1, 85764 Neuherberg, Germany"},{"name":"Deutsches Konsortium f\u00fcr Translationale Krebsforschung (DKTK), Partner Site Munich, Pettenkoferstra\u00dfe 8a, 80336 M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.radonc.2015.01.011","article-title":"Long-term 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