Pretreatment Growth Rate Predicts Radiation Response in Vestibular Schwannomas

Surgical salvage of recurrent vestibular schwannoma following prior stereotactic radiosurgery

“…In the authors' experience, approximately 6% of patients who receive primary SRS experience treatment failure at 5 to 7 years following radiation . This number may be greater for cystic, large, or rapidly growing tumors—or in cases where less than 12 Gy to the tumor margin is prescribed . Data regarding the utility of radiation therapy for treatment of residual progressive disease following subtotal resection is mixed.…”

Rapid growth rate is associated with poor prognosis in cutaneous squamous cell carcinoma

“…Greater GR has been associated with poor outcome in lung cancer, 8 renal cell carcinoma, 9 breast cancer, 10 laryngeal SCC 11 and melanoma 12 in cases where GR is associated with the presence of a positive sentinel lymph node (SLN). 13 In addition, GR has been associated with response to cancer treatment, 14,15 disease-free survival and time until metastasis dissemination. 16,17 Clinical evidence suggests that GR is an important risk factor in cSCC, 18 but its association with the disease has been poorly assessed.…”

Impact of pretreatment growth on Tumor control for vestibular schwannomas following gamma knife

“…In a recent series of 68 tumors, Marston et al found that pretreatment growth >2.5 mm/yr in maximal dimension decreased tumor control rates compared to slower pretreatment growth rates (69% vs. 97% control, respectively) . Similarly, in a study of 58 patients, Niu et al found that tumors with treatment failure (defined as > 20% volume increase after treatment) had a median pretreatment growth rate of 89% volume change per year, whereas tumors that were controlled had a median pretreatment growth rate of 41% volume change per year ( P = .02) . Varughese et al found a nonsignificant trend toward better control in slower‐growing tumors in a series of 45 tumors .…”

“…Prior studies examining the impact of pretreatment growth on SRS control rates have shown conflicting results . Some studies have relied upon linear measurements of tumor size, which are limited in the accuracy of representation of the often complex three‐dimensional shape of a tumor, especially after a partial resection.…”

“…Prior studies examining the impact of pretreatment growth on SRS control rates have shown conflicting results. [9][10][11][12] Some studies have relied upon linear measurements of tumor size, which are limited in the accuracy of representation of the often complex threedimensional shape of a tumor, especially after a partial resection. Additionally, short follow-up duration has been an important limitation in many prior studies, as VS are known to have transient growth even up to 5 years following SRS treatment that can take several years to resolve.…”