Radiosurgery in trochlear and abducens nerve schwannomas: case series and systematic review

Peciu-Florianu, Iulia; Tuleasca, Constantin; Schiappacasse, Luis; Zeverino, M.; Daniel, Roy Thomas; Levivier, Marc

doi:10.1007/s00701-017-3348-0

Cited by 25 publications

(21 citation statements)

References 59 publications

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“…For example, in vestibular schwannomas, the used radiation doses were initially higher, followed subsequently by dose escalation, with similar tumor control rates and better clinical outcomes [20]. Large tumors can be treated using subtotal or gross total resection followed by GKR, as previously published in non-vestibular [8,29,49] and vestibular schwannomas [8,46]. Other approaches might include staged volume radiosurgery, in selected cases [7].…”

Section: Discussionmentioning

confidence: 99%

“…Stereotactic radiosurgery (SRS) is considered a valuable therapeutic alternative for treating benign intracranial tumors, due to its minimal invasiveness as well as to its safety profile and efficacy on vestibular [14,24,34,44,45] and nonvestibular schwannomas [7,29]. Twenty years ago, a first report by Huang et al [16] evaluated the role of SRS by Gamma Knife (GK) in trigeminal nerve schwannomas.…”

Section: Introductionmentioning

confidence: 99%

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Tumor control and trigeminal dysfunction improvement after stereotactic radiosurgery for trigeminal schwannomas: a systematic review and meta-analysis

Peciu-Florianu¹,

Régis²,

Levivier

et al. 2020

Neurosurg Rev

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Trigeminal nerve schwannomas (TS) are uncommon intracranial tumors, frequently presenting with debilitating trigeminal and/or oculomotor nerve dysfunction. While surgical resection has been described, its morbidity and mortality rates are non-negligible. Stereotactic radiosurgery (SRS) has emerged with variable results as a valuable alternative. Here, we aimed at reviewing the medical literature on TS treated with SRS so as to investigate rates of tumor control and symptomatic improvement. We reviewed manuscripts published between January 1990 and December 2019 on PubMed. Tumor control and symptomatic improvement rates were evaluated with separate meta-analyses. This meta-analysis included 18 studies comprising a total of 564 patients. Among them, only one reported the outcomes of linear accelerators (Linac), while the others of GK. Tumor control rates after SRS were 92.3% (range 90.1–94.5; p < 0.001), and tumor decrease rates were 62.7% (range 54.3–71, p < 0.001). Tumor progression rates were 9.4% (range 6.8–11.9, p < 0.001). Clinical improvement rates of trigeminal neuralgia were 63.5% (52.9–74.1, p < 0.001) and of oculomotor nerves were 48.2% (range 36–60.5, p < 0.001). Clinical worsening rate was 10.7% (range 7.6–13.8, p < 0.001). Stereotactic radiosurgery for TS is associated with high tumor control rates and favorable clinical outcomes, especially for trigeminal neuralgia and oculomotor nerves. However, patients should be correctly advised about the risk of tumor progression and potential clinical worsening. Future clinical studies should focus on standard reporting of clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tumor control and trigeminal dysfunction improvement after stereotactic radiosurgery for trigeminal schwannomas: a systematic review and meta-analysis

Peciu-Florianu¹,

Régis²,

Levivier

et al. 2020

Neurosurg Rev

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“…OMNS have been divided into 4 types based on their location: cisternal, cavernous, cisterno-cavernous, and orbito-cavernous (Table 1). 65,66…”

Section: Oculomotor Nerve Schwannomas (Omns) Classificationmentioning

confidence: 99%

“…Symptoms can vary from incomplete oculomotor palsy and exophthalmos to brainstem compression signs. 65 A systematic review has summarized the most frequent symptoms (Table 1). 64…”

Section: Symptoms and Signsmentioning

confidence: 99%

Trends in the Management of Non-Vestibular Skull Base and Intracranial Schwannomas

Suárez¹,

López²,

Mendenhall³

et al. 2021

CMAR

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The aim of this review is to analyze the latest trends in the management of nonvestibular skull base and intracranial schwannomas in order to optimize tumor control and quality of life. Non-vestibular cranial nerve schwannomas are rare lesions, representing 5-10% of cranial nerve schwannomas. Management decisions should be individualized depending on tumor size, location and associated functional deficits. Generally, large sized schwannomas exerting significant mass effect with increased intracranial pressure are treated surgically. In some cases, even after optimal skull base resection, it is not possible to achieve a gross total resection because tumor location and extent and/or to reduce morbidity. Thus, subtotal resection followed by stereotactic radiosurgery or fractioned radiotherapy offers an alternative approach. In certain cases, stereotactic radiosurgery or radiotherapy alone achieves good tumor control rates and less morbidity to gross total resection. Finally, given the slow growth rate of most of these tumors, observation with periodic radiographic follow-up approach is also a reasonable alternative for small tumors with few, if any, symptoms.

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“…In slowly progressive cases, radiotherapy may be considered as an alternative treatment modality. In particular, gamma knife stereotactic radiosurgery has recently delivered promising results with small case series reporting reduced tumour volume and improvement of diplopia …”

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confidence: 99%

Trochlear nerve schwannoma: A 22 year follow‐up

Lock

Biousse

Newman

2019

Clinical Exper Ophthalmology

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Radiosurgery in trochlear and abducens nerve schwannomas: case series and systematic review

Cited by 25 publications

References 59 publications

Tumor control and trigeminal dysfunction improvement after stereotactic radiosurgery for trigeminal schwannomas: a systematic review and meta-analysis

Tumor control and trigeminal dysfunction improvement after stereotactic radiosurgery for trigeminal schwannomas: a systematic review and meta-analysis

Trends in the Management of Non-Vestibular Skull Base and Intracranial Schwannomas

Trochlear nerve schwannoma: A 22 year follow‐up

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