Would you favor conventional fractionation over hypofractionation/SRS for a young patient with "cellular" schwannoma (Ki-67 up to 30% focally) that has regrown to a Koos grade 3 within 2 years after initial resection?
Based on Shinya et al 2023 (PMID: 37283526), high Ki-67 predicts for much worse local control in mengingioma, but not sure if conventional fractionation mitigates this, or if this is applicable to schwannoma. Any radiobiological considerations? Given young age would prolonged fractionation increase risk of second malignancy/malignant transformation?