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Although radiosurgery has been well accepted as a treatment for small- to medium-sized vestibular schwannomas (VSs), its application in the treatment of large VSs remains controversial because of unfavorable effects such as tumor swelling and potential compression of the brainstem. The authors present a retrospective study spanning 17 years, during which 21 patients underwent Gamma Knife surgery (GKS) for large VSs. Long-term outcomes are reported, and possible factors affecting tumor responses to GKS are analyzed.

Five hundred thirteen patients harboring VSs underwent GKS between March 1993 and October 2009. A large VS was defined as a tumor whose diameter was > 3 cm. This paper focuses on 21 patients who harbored large VSs ranging in volume from 12.7 to 25.2 cm ³ (mean 17.3 cm ³ ) and …