Results of Outpatient Gamma Knife Radiosurgery for Primary Therapy of Acoustic Neuromas

Muacevic, Alexander; Jess-Hempen, Anja; Tonn, Joerg C.; Wowra, Berndt

doi:10.1007/978-3-7091-0583-2_8

Cited by 12 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,13,19,23 However, 97% of our patients did not require microsurgery, which is well within the range of the 95%-99% rates observed in other studies. 3,13,15,19 The CN complication and hearing preservation rates we observed here do not appear to be different from those reported in previous studies. 3,5,7,13 In the following, we will discuss several possible explanations for these findings.…”

Section: Discussionsupporting

confidence: 87%

“…3,13,15,19 The CN complication and hearing preservation rates we observed here do not appear to be different from those reported in previous studies. 3,5,7,13 In the following, we will discuss several possible explanations for these findings.…”

Section: Discussioncontrasting

confidence: 61%

“…After applying our exclusion criteria, 8 articles remained in our literature-based analysis. 1,3,5,7,13,15,19,23 The tumor control and complication rates in these published cohorts are summarized in Table 4.…”

Section: Literature Searchmentioning

confidence: 99%

“…However, such large tumors are incidentally treated with radiosurgery when microsurgery is contraindicated because of comorbidities or high age, or when hearing preservation is of paramount importance. Until late 2010, we prescribed a dose of [11][12][13] Gy to the isodose covering 90% of the tumor volume, ensuring a marginal dose of approximately 11 Gy.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Gamma Knife radiosurgery for vestibular schwannomas: evaluation of tumor control and its predictors in a large patient cohort in The Netherlands

Klijn

Verheul

Beute

et al. 2016

JNS

View full text Add to dashboard Cite

OBJECT The authors of this study sought to assess tumor control and complication rates in a large cohort of patients who underwent Gamma Knife radiosurgery (GKRS) for vestibular schwannoma (VS) and to identify predictors of tumor control. METHODS The records of 420 patients treated with GKRS for VS with a median marginal dose of 11 Gy were retrospectively analyzed. Patients with neurofibromatosis Type 2 or who had undergone treatment for VS previously were excluded. The authors assessed tumor control and complication rates with chart review and used the Cox proportional hazards model to identify predictors of tumor control. Preservation of serviceable hearing, defined as Gardner-Robertson Class I–II, was evaluated in a subgroup of 71 patients with serviceable hearing at baseline and with available follow-up audiograms. RESULTS The median VS tumor volume was 1.4 cm3, and the median length of follow-up was 5.1 years. Actuarial 5-and 10-year tumor control rates were 91.3% and 84.8%, respectively. Only tumor volume was a statistically significant predictor of tumor control rate. The tumor control rate decreased from 94.1% for tumors smaller than 0.5 cm3 to 80.7% for tumors larger than 6 cm3. Thirteen patients (3.1%) had new or increased permanent trigeminal nerve neuropathy, 4 (1.0%) had new or increased permanent facial weakness, and 5 (1.2%) exhibited new or increased hydrocephalus requiring a shunting procedure. Actuarial 3-year and 5-year hearing preservation rates were 65% and 42%, respectively. CONCLUSIONS The 5-year actuarial tumor control rate of 91.3% in this cohort of patients with VS compared slightly unfavorably with the rates reported in other large studies, but the complication and hearing preservation rates in this study were similar to those reported previously. Various factors may contribute to the observed differences in reported outcomes. These factors include variations in treatment indication and in the definition of treatment failure, as well as a lack of standardization of terminology and of evaluation of complications. Last, differences in dosimetric variables may also be an explanatory factor.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 61%

Section: Literature Searchmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Gamma Knife radiosurgery for vestibular schwannomas: evaluation of tumor control and its predictors in a large patient cohort in The Netherlands

Klijn

Verheul

Beute

et al. 2016

JNS

View full text Add to dashboard Cite

show abstract

“…4,5,23,47,48 Despite the availability of published data that highlights the clinical, radiographic, and biological parameters when managing VS patients with radiosurgery, predicting hearing preservation after radiosurgery remains a challenge for practitioners. 14,36,40,[49][50][51][52] This difficulty may result from most studies having been small to modest in size, frequently from a single institution, and lacking statistical power and freedom from potential practitioner bias to draw firm conclusions. In our review we found impressive variations in reported hearing preservation outcomes for VS patients treated with radiosurgery.…”

Section: Introductionmentioning

confidence: 96%