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27.09.2022 | Research

Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in young patients: a multi-institutional study

verfasst von: Chloe Dumot, Stylianos Pikis, Georgios Mantziaris, Zhiyuan Xu, Rithika Kormath Anand, Ahmed M. Nabeel, Darrah Sheehan, Kimball Sheehan, Wael A. Reda, Sameh R. Tawadros, Khaled Abdel Karim, Amr M. N. El-Shehaby, Reem M. Emad Eldin, Selcuk Peker, Yavuz Samanci, Tehila Kaisman-Elbaz, Herwin Speckter, Wenceslao Hernández, Julio Isidor, Manjul Tripathi, Renu Madan, Brad E. Zacharia, Lekhaj C. Daggubati, Nuria Martínez Moreno, Roberto Martínez Álvarez, Anne-Marie Langlois, David Mathieu, Christopher P. Deibert, Vivek R. Sudhakar, Christopher P. Cifarelli, Denisse Arteaga Icaza, Daniel T. Cifarelli, Zhishuo Wei, Ajay Niranjan, Gene H. Barnett, L. Dade Lunsford, Greg N. Bowden, Jason P. Sheehan

Erschienen in: Journal of Neuro-Oncology | Ausgabe 1/2022

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Abstract

Purpose

Surgery is the treatment of choice for large vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has been suggested as an alternative to resection in selected patients. However, the safety and efficacy of SRS in Koos grade IV patients ≤ 45 years old has not been evaluated. The aim of this study is to describe the clinical and radiological outcomes of Koos grade IV in young patient managed with a single-session SRS.

Methods

This retrospective, multicenter analysis included SRS-treated patients, ≤ 45 years old presenting with non-life threatening or incapacitating symptoms due to a Koos Grade IV VS and with follow-up ≥ 12 months. Tumor control and neurological outcomes were evaluated.

Results

176 patients [median age of 36.0 (IQR 9) and median tumor volume of 9.3 cm³ (IQR 4.7)] were included. The median prescription dose was 12 Gy (IQR 0.5). Median follow-up period was 37.5 (IQR 53.5) months. The 5- and 10-year progression-free survival was 90.9% and 86.7%. Early tumor enlargement occurred in 10.9% of cases and was associated with tumor progression at the last follow-up. The probability of serviceable hearing preservation at 5- and 10-years was 56.8% and 45.2%, respectively. The probability of improvement or preservation of facial nerve function was 95.7% at 5 and 10-years. Adverse radiation effects were noted in 19.9%. New-onset hydrocephalus occurred in 4.0%.

Conclusion

Single-session SRS is a safe and effective alternative to surgical resection in selected patients ≤ 45 years old particularly those with medical co-morbidities and those who decline resection. Longer term follow up is warranted.

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Titel: Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in young patients: a multi-institutional study
verfasst von: Chloe Dumot
Stylianos Pikis
Georgios Mantziaris
Zhiyuan Xu
Rithika Kormath Anand
Ahmed M. Nabeel
Darrah Sheehan
Kimball Sheehan
Wael A. Reda
Sameh R. Tawadros
Khaled Abdel Karim
Amr M. N. El-Shehaby
Reem M. Emad Eldin
Selcuk Peker
Yavuz Samanci
Tehila Kaisman-Elbaz
Herwin Speckter
Wenceslao Hernández
Julio Isidor
Manjul Tripathi
Renu Madan
Brad E. Zacharia
Lekhaj C. Daggubati
Nuria Martínez Moreno
Roberto Martínez Álvarez
Anne-Marie Langlois
David Mathieu
Christopher P. Deibert
Vivek R. Sudhakar
Christopher P. Cifarelli
Denisse Arteaga Icaza
Daniel T. Cifarelli
Zhishuo Wei
Ajay Niranjan
Gene H. Barnett
L. Dade Lunsford
Greg N. Bowden
Jason P. Sheehan
Publikationsdatum: 27.09.2022
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 1/2022
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-022-04134-0

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