Comparative analysis of different modalities of radiotherapy in vestibular schwannoma: tumor control, symptom evolution, and toxicity profiles

Both SRS and NFSRT achieve excellent long-term tumor control with low severe toxicity. For NFSRT, normofractionated doses above 55 Gy did not improve efficacy and may increase the recurrence risk, supporting moderate-dose regimens (50-54 Gy). Symptom stabilization confirms the safety of SRT, though headache and vertigo remain relevant long-term issues. Careful dose selection, patient counseling, and rehabilitation are essential to optimize outcomes.