Is Proton Therapy Superior to Gamma Knife Radiosurgery for Sporadic Vestibular Schwannoma?

With changing practice patterns, radiation therapy for vestibular schwannomas has become an increasingly utilized treatment modality with high tumor control rates. Gamma-Knife radiosurgery remains a well-established and readily accessible option with good rates for tumor control, cranial nerve preservation, and hearing outcomes. Proton beam therapy, which theoretically allows for more precise radiation delivery, remains less accessible, and, based on current evidence, it has not demonstrated superior outcomes to Gamma-Knife.