Quality of Life in 807 Patients with Vestibular Schwannoma: Comparing Treatment Modalities

Abstract

Objective In vestibular schwannoma treatment, the choice among treatment modalities is controversial. The first aim of this study was to examine the quality of life of patients with vestibular schwannoma having undergone observation, radiation therapy, or microsurgical resection. The second aim was to examine the relationship between perceived symptoms and quality of life. Last, the association between quality of life and time since treatment was studied. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods A total of 1208 patients treated for sporadic vestibular schwannoma between 2004 and 2014 were mailed the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and additional questions on symptoms associated with vestibular schwannoma. Total and domain scores were calculated and compared among treatment groups. Propensity scores were used, and results were stratified according to tumor size to control for potential confounders. Correlations were calculated to examine the relationship between self-reported symptoms and quality of life, as well as between quality of life and time since treatment. Results Patients with small tumors (≤10 mm) under observation showed a higher PANQOL score when compared with the radiation therapy and microsurgical resection groups. A strong negative correlation was found between self-reported symptoms and quality of life, with balance problems and vertigo having the largest impact. No correlation was found between PANQOL score and time since treatment. Conclusion This study suggests that patients with small vestibular schwannomas experience better quality of life when managed with observation than do patients who have undergone active treatment.

Quality of life in the management of small vestibular schwannomas: Observation, radiotherapy and microsurgery

“…Three studies showed that MS patients had worse QOL than those in the other groups . Soulier et al reported better QOL in patients with small tumours (<10 mm) undergoing observation because there was no active treatment, so patients did not feel sick. Betchen et al showed that postoperative hearing, facial functioning and time since MS had no significant impact on QOL as assessed by the SF‐36.…”

Trends in hearing rehabilitation use among vestibular schwannoma patients

“…Patients with smaller VSs report a higher overall quality of life when managed with observation compared to surgical intervention, even when controlling for hearing preservation microsurgical approaches . Among patients undergoing treatment, those with smaller tumors approached with either surgery or stereotactic radiation have higher rates of hearing preservation and higher overall quality of life than those with larger tumors .…”

Comparison of balance outcomes according to treatment modality of vestibular schwannoma

“…Thus, 34 studies (n = 5,560) met the selection criteria and were included in the analysis (Fig. , Table ) …”

“…Five studies compared three interventions (MS, RT, and OB). MS and RT were compared in five studies, whereas MS and OB were compared in one .…”

“…Of the studies, 14 were conducted in the United States, whereas two studies were conducted in both the United States and Europe . The remaining 18 were conducted in Germany, France, Norway, Korea, the Netherlands, Australia, Austria, England, Denmark, Italy, Spain, and Japan …”