Control Z 3x6
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Patient data were collected retrospectively by using information documented in the patient history and from clinical assessments during follow-up. Furthermore, an adapted questionnaire was sent to all 261 patients. This questionnaire is called Heidelberg SYQOL Inventory: questionnaire on symptom control, outcome, and quality of life (QOL) for self-reported outcome. It was initially developed by Combs et al.  and applied in a large cohort treated by SRS and FRT. This questionnaire was completed by 168 patients (64.4%). The Heidelberg SYQOL Inventory explicitly refers to typical symptoms, side effects, long-term outcome, and quality of life of patients with VS prior to RT and after treatment. A detailed survey about hearing ability after RT was also included. We asked for hearing function with the ipsilateral and contralateral ear in situations with different levels of background noises as well as differences in hearing ability with the use of a hearing aid. Overall, the Heidelberg SYQOL Inventory differs from conventional instruments and is particularly suitable for recording symptoms and QOL of patients with VS.
Stereotactic radiotherapy has become a standard non-invasive treatment alternative to surgery, especially for small to medium-sized VS. Regarding local tumor control, hearing preservation, cranial nerve toxicity and QOL, RT has an equal or even more beneficial risk profile compared to surgery in smaller tumors. However, surgery is preferred for larger lesions with brain stem contact or for irregularly shaped lesions, and FRT can be used if surgery is not feasible. Previous data indicate that stereotactic radiotherapy can achieve similar results to surgery regarding local control and hearing preservation . Moreover, it is known that RT enables lower treatment related cranial nerve toxicity than surgery [6,7,8].
In a recent study, Koetsier et al.  reported on patients with VS treated with protons. The study was retrospective and chart-based, only regarding the investigation of post-irradiation symptoms. Of the total patients studied, 136 received single-fraction proton therapy and 85 patients received FPT. The 5-year local control rate was 96% with a median follow-up of 4.5 years. Progressive post-irradiation speech discrimination score loss occurred in 42% of patients with audiometric follow-up within a year. Facial paresis was found in 5%, severe dizziness in 5%, and trigeminal neuralgia in 5% of patients . Comparable to our study, trigeminal neuralgia occurred more often in patients with larger tumor volumes and in patients that received FPT (p = 0.0496). Cochlear mean dose was 43.4 Gy (RBE) for patients treated with FPT .
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One important fact to note is that although there is only one transfer function that describes a system, you can have multiple state-space equations that describe a system. The tf2ss command returns the state-space matrices in control canonical form. Therefore, if you take a set of state-space equations, convert them into a transfer function, and then convert it back, you will not have the same set of state-space equations you started with unless you started with matrices in control canonical form.
This is obviously not the same set of matrices that were initially used, but the input-output behavior of this system is the same as that of the previous one. There are infinitely many ways to represent a given transfer function in state-space form; MATLAB chooses the control canonical form. The states will not have the same meaning as they originally did.
Again, it is important to note that more than one set of state-space matrices can describe a system. The state-space matrices returned from this command are also in control canonical form. For example, take the z, p, and k matrices you just created and convert them back to state-space:
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