The Effect of Cochlear Dose on Hearing Preservation After Low-Dose Stereotactic Radiosurgery for Vestibular Schwannomas: A Systematic Review

Govindaraj, Ramkumar; Khong, Jeremy; Byrne, Adam; Zacest, Andrew C.; Roos, Daniel

doi:10.1016/j.adro.2022.101059

Cited by 9 publications

(8 citation statements)

References 52 publications

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“…In another study, which compared GammaKnife, LINAC-based, and CyberKnife radiosurgery in relatively smaller vestibular schwannomas, LINAC provided the best conformity and GammaKnife the best gradient index [40] . The reported Paddick’s conformity index is better in the current study than in several other studies: 0.78–––0.85 in the current study versus 0.66–––0.76 (all without utilizing treatment margins or set-up robustness) [37] , [40] .…”

Section: Discussioncontrasting

confidence: 65%

“…There is a lack of normal tissue complication probability (NTCP) models for hearing loss based on cochlear dose in vestibular schwannoma patients undergoing radiosurgery [11] . Previous photon radiosurgery studies suggest that better hearing outcomes can be obtained by reducing the mean doses < 3–6 Gy, the maximum doses < 4–12 Gy, and minimum doses < 5–6 Gy [37] , [38] . No established gold standard for radiotherapy exists for vestibular schwannoma patients, and differences in local practices (i.e., patient selection) and endpoint definitions (Dmean, Dmin, Dmax, D90, V90, cochlear modiolus dose) make it difficult to compare different modalities [10] , [14] , [33] .…”

Section: Discussionmentioning

confidence: 99%

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Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Koetsier,

Oud,

de Klerck

et al. 2023

Clinical and Translational Radiation Oncology

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Koetsier,

Oud,

de Klerck

et al. 2023

Clinical and Translational Radiation Oncology

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“…Although some authors have asserted a strong connection between SRS treatment parameters such as cochlear dose and hearing loss after SRS, this remains controversial and is not uniformly considered in treatment planning. Therefore, associations between cochlear dose and hearing loss in the repeat SRS setting were not examined (42,43).…”

Section: Discussionmentioning

confidence: 99%

Repeat Radiosurgery for Sporadic Vestibular Schwannoma After Primary Radiosurgical Failure: An International Multi-institutional Investigation

Khandalavala,

Herberg,

Kay-Rivest

et al. 2024

Otol Neurotol

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Objective To describe outcomes of patients with sporadic vestibular schwannoma (VS) who underwent repeat stereotactic radiosurgery (SRS) after primary SRS failure. Study Design Multi-institutional historical cohort study. Setting Five tertiary care referral centers. Patients Adults ≥18 years old with sporadic VS. Intervention Primary and repeat treatment with SRS. Main Outcome Measure Microsurgery-free survival after repeat SRS. Results Across institutions, 32 patients underwent repeat SRS after primary SRS. Most patients (74%) had tumors with cerebellopontine angle extension at primary SRS (median size, 13.5 mm [interquartile range, 7.5–18.8] mm). After primary SRS, patients underwent repeat SRS at a median of 4.8 years (interquartile range, 3.2–5.7 yr). For treatment modality, 30 (94%) patients received gamma knife for primary treatment and 31 (97%) patients received gamma knife as their repeat treatment. Median tumor volume increased from 0.970 cm3 at primary SRS to 2.200 cm3 at repeat SRS. Facial nerve function worsened in two patients after primary SRS and in two patients after repeat SRS. There were no instances of intracranial complications after repeat SRS. Microsurgery-free survival rates (95% confidence interval; number still at risk) at 1, 3, and 5 years after repeat SRS were 97% (90–100%, 24), 84% (71–100%, 13), and 68% (48–96%, 6), respectively. There was one occurrence of malignancy diagnosed after repeat radiosurgery. Conclusion Overall, repeat SRS for sporadic VS has comparable risk profile, but lower rates of tumor control, compared with primary SRS.

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“…A maximum point dose of 12.5 Gy for uninvolved brainstem was also given 13 . For the clinical plans, a cochlea mean dose of 6 Gy was used as the OAR constraint 14,15 . When cochlea abutted the GTV, planners planned for mean dose as low as reasonably achievable while not compromising TC.…”

Section: Methodsmentioning

confidence: 99%

“…13 For the clinical plans, a cochlea mean dose of 6 Gy was used as the OAR constraint. 14,15 When cochlea abutted the GTV, planners planned for mean dose as low as reasonably achievable while not compromising TC. MFP and FIP were performed as follows.…”

Section: Treatment Planningmentioning

confidence: 99%

A study on inter‐planner plan quality variability using a manual planning‐ or Lightning dose optimizer‐approach for single brain lesions treated with the Gamma Knife^® Icon™

Lee

Wieczorek

Chaswal

et al. 2023

J Applied Clin Med Phys

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PurposeThe purpose of this study is to investigate inter‐planner plan quality variability using a manual forward planning (MFP)‐ or fast inverse planning (FIP, Lightning)‐approach for single brain lesions treated with the Gamma Knife® (GK) Icon™.MethodsThirty patients who were previously treated with GK stereotactic radiosurgery or radiotherapy were selected and divided into three groups (post‐operative resection cavity, intact brain metastasis, and vestibular schwannoma [10 patients per group]). Clinical plans for the 30 patients were generated by multiple planners using FIP only (1), a combination of FIP and MFP (12), and MFP only (17). Three planners (Senior, Junior, and Novice) with varying experience levels re‐planned the 30 patients using MFP and FIP (two plans per patient) with planning time limit of 60 min. Statistical analysis was performed to compare plan quality metrics (Paddick conformity index, gradient index, number of shots, prescription isodose line, target coverage, beam‐on‐time (BOT), and organs‐at‐risk doses) of MFP or FIP plans among three planners and to compare plan quality metrics between each planner's MFP/FIP plans and clinical plans. Variability in FIP parameter settings (BOT, low dose, and target max dose) and in planning time among the planners was also evaluated.ResultsVariations in plan quality metrics of FIP plans among three planners were smaller than those of MFP plans for all three groups. Junior's MFP plans were the most comparable to the clinical plans, whereas Senior's and Novice's MFP plans were superior and inferior, respectively. All three planners’ FIP plans were comparable or superior to the clinical plans. Differences in FIP parameter settings among the planners were observed. Planning time was shorter and variations in planning time among the planners were smaller for FIP plans in all three groups.ConclusionsThe FIP approach is less planner dependent and more time‐honored than the MFP approach.

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The Effect of Cochlear Dose on Hearing Preservation After Low-Dose Stereotactic Radiosurgery for Vestibular Schwannomas: A Systematic Review

Cited by 9 publications

References 52 publications

Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Repeat Radiosurgery for Sporadic Vestibular Schwannoma After Primary Radiosurgical Failure: An International Multi-institutional Investigation

A study on inter‐planner plan quality variability using a manual planning‐ or Lightning dose optimizer‐approach for single brain lesions treated with the Gamma Knife^® Icon™

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The Effect of Cochlear Dose on Hearing Preservation After Low-Dose Stereotactic Radiosurgery for Vestibular Schwannomas: A Systematic Review

Cited by 9 publications

References 52 publications

Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Cochlear-optimized treatment planning in photon and proton radiosurgery for vestibular schwannoma patients

Repeat Radiosurgery for Sporadic Vestibular Schwannoma After Primary Radiosurgical Failure: An International Multi-institutional Investigation

A study on inter‐planner plan quality variability using a manual planning‐ or Lightning dose optimizer‐approach for single brain lesions treated with the Gamma Knife® Icon™

Contact Info

Product

Resources

About

A study on inter‐planner plan quality variability using a manual planning‐ or Lightning dose optimizer‐approach for single brain lesions treated with the Gamma Knife^® Icon™