Vestibular schwannomas: Clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 2005;56:927-935

Myrseth, Erling; Möller, Per; Pedersen, Paal‐Henning; Vassbotn, Flemming S.; Wentzel‐Larsen, Tore; Lund‐Johansen, Morten

doi:10.1055/s-2005-925545

Cited by 60 publications

(94 citation statements)

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“…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%

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

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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.

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Section: Literature Searchmentioning

confidence: 99%

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

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“…Treatment decisions are usually based on multidisciplinary education of the patient [33]. Large single-institution retrospective series [34] and, more recently, two prospective series seem to indicate better neurological outcomes for acoustic neuromas with radiosurgery compared to surgery [35,36] and probably equivalent long-term control for meningiomas [37].…”

Section: Hypofractionatedmentioning

confidence: 99%

Clinical outcome after Hypofractionated Stereotactic Radiotherapy (HSRT) for benign skull base tumors

Mahadevan¹,

Floyd²,

Wong

et al. 2011

Computer Aided Surgery

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“…In particular, radiation toxicity of neuro-anatomic structures adjacent to the tumor may develop and manifest as impaired function of the facial nerve, hearing loss, or loss of equilibrium and balance. [14,16,17,23,27,30,[34][35][36][37][38][39][40][41]. Hydrocephalus, cerebral edema, and other cranial neuropathies have also been documented after GKRS, and in some reported cases required shunting as a treatment for hydrocephalus [4,23,37,[42][43][44][45][46][47][48][49].…”

Section: Introductionmentioning

confidence: 99%

Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery

et al. 2009

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Objective Facial nerve preservation is a critical measure of clinical outcome after vestibular schwannoma treatment. Gamma Knife radiosurgery has evolved into a practical treatment modality for vestibular schwannoma patients, with several reported series from a variety of centers. In this study, we report the results of an objective analysis of reported facial nerve outcomes after the treatment of vestibular schwannomas with Gamma Knife radiosurgery. Materials and methods A Boolean Pub Med search of the English language literature revealed a total of 23 published studies reporting assessable and quantifiable outcome data regarding facial nerve function in 2,204 patients who were treated with Gamma Knife radiosurgery for vestibular schwannoma. Inclusion criteria for articles were: (1) Facial nerve preservation rates were reported specifically for vestibular schwannoma, (2) Facial nerve functional outcome was reported using the House-Brackmann classification (HBC) for facial nerve function, (3) Tumor size was documented, and (4) Gamma Knife radiosurgery was the only radiosurgical modality used in the report. The data were then aggregated and analyzed based on radiation doses delivered, tumor volume, and patient age. Results An overall facial nerve preservation rate of 96.2% was found after Gamma Knife radiosurgery for vestibular schwannoma in our analysis. Patients receiving less than or equal to 13 Gy of radiation at the marginal dose had a better facial nerve preservation rate than those who received higher doses (B13 Gy = 98.5% vs. [13 Gy = 94.7%, P \ 0.0001). Patients with a tumor volume less than or equal to 1.5 cm 3 also had a greater facial nerve preservation rate than patients with tumors greater than 1.5 cm 3 (B1.5 cm 3 99.5% vs. [1.5 cm 3 95.5%, P \ 0.0001). Superior facial nerve preservation was also noted in patients younger than or equal to 60 years of age (96.8 vs. 89.4%, P \ 0.0001). The average reported follow up duration in this systematic review was 54.1 ± 31.3 months. Conclusion Our analysis of case series data aggregated from multiple centers suggests that a facial nerve preservation rate of 96.2% can be expected after Gamma knife radiosurgery for vestibular schwannoma. Younger patients with smaller tumors less than 1.5 cm 3 and treated with lower doses of radiation less than 13 Gy will likely have better facial nerve preservation rates after Gamma Knife radiosurgery for vestibular schwannoma.

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Vestibular schwannomas: Clinical results and quality of life after microsurgery or gamma knife radiosurgery. Neurosurgery 2005;56:927-935

Cited by 60 publications

References 0 publications

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

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

Clinical outcome after Hypofractionated Stereotactic Radiotherapy (HSRT) for benign skull base tumors

Facial nerve preservation after vestibular schwannoma Gamma Knife radiosurgery

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