Management of vestibular schwannoma in the modern era: Early clinical outcomes

Objectives: To evaluate clinical characteristics, treatment approaches, dosimetrist parameters, and early outcomes in patients with vestibular schwannoma treated with radiotherapy. Material and Methods: This retrospective observational study analyzed patients with vestibular schwannoma treated with radiotherapy between 2022 and 2025. Demographic, clinical, radiological, audiometric, and dosimetrist parameters were evaluated. Treatment outcomes, including radiologic response, hearing outcomes, and treatment-related toxicity, were also reviewed. Descriptive statistics and exploratory non-parametric analyses were performed. Results: Ten patients were included, with a median age of 32 years. fractionated stereotactic radiotherapy (FSRT) and volumetric modulated arc therapy (VMAT) were used in five patients each. At a median follow-up of 10.5 months, no radiologic progression was observed in any patient. Three patients (30%) demonstrated complete radiologic response, while seven (70%) showed stable disease. Hearing preservation was achieved in only one patient. Treatment was well tolerated, with no Grade 3 or 4 toxicities and no life-threatening adverse events. Conclusion: Precision radiotherapy using FSRT or VMAT provides excellent tumor control with acceptable toxicity in vestibular schwannoma. Larger studies with longer follow-up are required to evaluate long-term functional outcomes.