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Persistent Oxidative Stress in Vestibular Schwannomas After Stereotactic Radiation Therapy
Journal article   Open access   Peer reviewed

Persistent Oxidative Stress in Vestibular Schwannomas After Stereotactic Radiation Therapy

Zachary N Robinett, Girish Bathla, Angela Wu, James Jason Clark, Zita A Sibenaller, Thomas Wilson, Patricia Kirby, Bryan G Allen and Marlan R Hansen
Otology & neurotology, Vol.39(9), pp.1184-1190
10/2018
DOI: 10.1097/MAO.0000000000001935
PMCID: PMC6131037
PMID: 30106845
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6131037View
Open Access

Abstract

Stereotactic radiation therapy is increasingly used to treat vestibular schwannomas (VSs) primarily and to treat tumor remnants following microsurgery. Little data are available regarding the effects of radiation on VS cells. Tyrosine nitrosylation is a marker of oxidative stress following radiation in malignant tumors. It is not known how long irradiated tissue remains under oxidative stress, and if such modifications occur in benign neoplasms such as VSs treated with significantly lower doses of radiation. We immunostained sections from previously radiated VSs with an antibody that recognizes nitrosylated tyrosine residues to assess for ongoing oxidative stress. Immunohistochemical analysis. Four VSs, which recurred after excision, were treated with stereotactic radiation therapy. Ultimately each tumor required salvage reresection for regrowth. Histologic sections of each tumor before and after radiation were immunolabeled with a monoclonal antibody specific to nitrotyrosine and compared. Two VSs that underwent reresection of a growing tumor remnant without previous radiation therapy served as additional controls. Irradiated tumors enlarged in volume by 3.16 to 8.62 mL following radiation. Preradiation sections demonstrated little to no nitrotyrosine immunostaining. Three of four of irradiated VSs demonstrated increased nitrotyrosine immunostaining in the postradiation sections compared with preradiation tumor sections. Nonirradiated VSs did not label with the antinitrotyrosine antibody. VSs exhibit oxidative stress up to 7 years after radiotherapy, yet these VSs continued to enlarge. Thus, VSs that grow following radiation appear to possess mechanisms for cell survival and proliferation despite radiation-induced oxidative stress.
Neoplasm Recurrence, Local - radiotherapy Neuroma, Acoustic - radiotherapy Neoplasm Recurrence, Local - metabolism Humans Middle Aged Radiosurgery Neuroma, Acoustic - metabolism Oxidative Stress - radiation effects

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