NF2 is prominently in the news this week. Another July publication** tackles the controversial topic of whether or not stereotactic radiotherapy (SRT) can be safely used for the treatment of vestibular schwannomas or other tumors seen in NF2. The potential benefit of SRT is that it is non-invasive and can be used to treat multiple tumors in a single session. The potential concern of SRT is that it might trigger otherwise largely benign NF2 tumors into malignant cancer. This issue is hotly debated by clinicians on either side of the argument, and reports from case studies and individual clinics have supported both perspectives. Some clarity on this matter may now be shed by this paper which suggests risk of SRT-induced malignancy in NF2 might predominantly be in those individuals with a germline NF2 gene mutation (NF2 mutation can be detected in the blood as well as tumors), rather than those persons with a sporadic NF2 gene mutation (mutation can be detected in tumor but not in blood). Though early days, hopefully this finding could help unravel previous mixed findings and pave the way to a true clinical community consensus on using SRT in NF2. ** Carlson, Babovic-Vuskanovic, Messiaen, Scheithauer, Neff and Link (2009) Radiation induced rhabdomysosarcoma of the brainstem in patient with neurofibromatosis Type 2. Journal of Neurosurgery July 3.
New Light Shed on the NF2 Radiotherapy Debate?
