Hearing Outcomes Using Fractionated Proton Radiation Therapy for Vestibular Schwannoma

Inclusion Criteria

• •MRI confirmed unilateral vestibular schwannoma within 8 weeks prior to study entry
• •Measurable disease, defined as a lesion that can be accurately measured in at least one dimension
• •No prior radiotherapy with dose delivered to structures in proximity to the internal acoustic canal is allowable
• •Participants must have baseline "useful hearing" defined at the discretion of the treating physician in the irradiated ear
• •18 years of age or older
• •Life expectancy of greater than 60 months
• •Karnofsky performance status 60 or greater
• •Diagnosis of neurofibromatosis 2 (NF2) is permitted
• •Women of child-bearing potential and men must agree to use adequate contraception during the interval of irradiation
• •Able to tolerate the supine position as required for the radiation treatment unit and able to tolerate rotation needed for treatment delivery
• •Able to tolerate the standard immobilization device that typically utilizes a dental impression mouth piece and thus requires breathing through the nasal passage.
• •Willing and able to comply with comprehensive audiologic testing, at baseline prior to radiation therapy, at 6 months from treatment completion, and at annual timepoints for 5 years after completion
• •Baseline Systolic Blood Pressure (BP) \> 100mm Hg. This is based on the average of two values - separate seated, resting measurements taken five minutes apart. BP does not need to be checked in both arms unless a reading is below 110 mm Hg, in which case the other arm can be checked as well. If BP is checked in both arms, the higher value is deemed accurate for calculating the average.
• •HIV-positive individuals on combination antiretroviral therapy
• •Patients with co-existing major ear disease, such as chronic otitis, Menieres disease, or otosclerosis