Introduction
Patients and methods
Study population and study design
Quality of life questionnaires
Tumor size
Complications and audiovestibular symptoms
Gamma knife settings, procedure, and cochlear radiation dose
Statistics
Results and analysis
Group characteristics
Sex | 52 Male/45 female |
Mean age at VS diagnosis (years) | 53 (range 23–81) |
Mean age at GKRS (years) | 56 (range 24–84) |
Mean time between diagnosis and GKRS (months) | 27 (range 2–126) |
Tumor side | 58 Right (59.8%), 39 left (40.2%) |
Tumor location | 94 Extrameatal (96.9%), 3 intrameatal (3.1%) |
Mean tumor size extrameatal (mm) | 17 (range 6–39) |
Mean tumor volume before GKRS (mm3) | 2,721 (range 25–17,700) |
Mean (Gy) | Range (Gy) | SD | |
---|---|---|---|
Marginal dose | 11.1 | 9.3–12.5 | 0.45 |
Tumor dose 90% | 12.7 | 12–13.2 | 0.33 |
Maximal tumor dose | 19.9 | 16–25.5 | 1.7 |
Maximal cochlea dose | 10.4 | 5–16.1 | 2.69 |
General quality of life after GKRS
Study population n = 97 | Normal population [8] n = 1,742 | Unpaired t test (P value) | |
---|---|---|---|
Age receiving questionnaire | |||
Mean (SD) | 57.6 (13.3) | 47.6 (18.0) |
<0.0001
|
Range | 26–86 | 16–94 | |
Sex | |||
Male | 54% | 56% | |
Female | 46% | 44% | |
SF36 | |||
PF mean (SD) | 82.5 (20.9) | 83.0 (22.8) | 0.83 |
RP mean (SD) | 68 (40.6) | 76.4 (36.3) |
0.03
|
RE mean (SD) | 80.7 (36.2) | 82.3 (32.9) | 0.64 |
VT mean (SD) | 66.3 (22.4) | 68.6 (19.3) | 0.25 |
MH mean (SD) | 80.1 (15.8) | 76.8 (17.4) | 0.06 |
SF mean (SD) | 81.3 (22.1) | 84.0 (22.4) | 0.24 |
BP mean (SD) | 78.4 (22.1) | 74.9 (23.4) | 0.15 |
GH mean (SD) | 65.5 (20) | 70.7 (20.7) |
0.01
|
Quality of life change after treatment
Mean (n) | SD | Range | |
---|---|---|---|
Study population (n = 97) | |||
Total score | −0.1 (71) | 14.6 | −33.3 to 52.8 |
General subscale score | −1.4 (78) | 19.3 | −50 to 62.5 |
Social support subscale score | +6.7 (94) | 18.8 | −33.3 to 100 |
Physical health subscale score | −4.9 (91) | 12.5 | −50 to 33.3 |
n = 97 | Number of patients Before GKRS (%) | Number of patients After GKRS (%) | Decreased symptom (%) | Unaltered (%) | Increased symptom (%) |
---|---|---|---|---|---|
Tinnitus | 78 (80) | 84 (87) | 6 (6) | 67 (69) | 24 (25) |
Hearing impairment | 89 (92) | 93 (96) | 6 (6) | 70 (72) | 21 (22) |
Unsteadiness/vertigo | 64 (66) | 73 (75) | 7 (7) | 69 (71) | 21 (22) |
Facial function | 3 (3.1) | 10 (10) | 0 | 89 (92) | 8 (8) |
Trigeminal function | 17 (18) | 28 (29) | 4 (4) | 78 (80) | 15 (16) |
Headache | 47 (49) | 55 (57) | 6 (6) | 76 (78) | 15 (16) |
Discussion
SF36
Aaronson et al. [8] Normal Dutch population | Present study n = 97 After GKRS | Tufarelli et al. [10] n = 386 After MS | Nicoucar et al. [2] n = 72 After MS VS > 20 mm | |
---|---|---|---|---|
Age receiving questionnaire | ||||
Mean (SD) | 47.6 (18.0) | 57.6 (13.3) | 49 (12.1) | 50.8 (–) |
Range | 16–94 | 26–86 | – | – |
Sex | ||||
Male (%) | 56 | 54 | 54 | 43 |
Female (%) | 44 | 46 | 46 | 57 |
Mean tumor size | 17 mm (6–39) | Not mentioned | >20 mm | |
Elapsed mean time since treatment (Months) | 21 | 49 | 91 |
SF36 | Mean (SD) | Mean (SD) | Mean (SD) | Mean |
---|---|---|---|---|
PF | 83.0 (22.8) | 82.5 (20.9) | 77.8 (27.7) | 72.5 |
RP | 76.4 (36.3) | 68 (40.6) | 66.7 (40.6) | 56.6 |
RE | 82.3 (32.9) | 80.7 (36.2) | 67.7 (25.1) | 67.1 |
VT | 68.6 (19.3) | 66.3 (22.4) | 55.1 (23.9) | 55.1 |
MH | 76.8 (17.4) | 80.1 (15.8) | 61.7 (26.9) | 66.8 |
SF | 84.0 (22.4) | 81.3 (22.1) | 73.2 (25.4) | 65.8 |
BP | 74.9 (23.4) | 78.4 (22.1) | 67.9 (25.1) | – |
GH | 70.7 (20.7) | 65.5 (20) | 60.6 (25.5) | 68.2 |
GBI
Study population After GKRS (n = 97) | Nikolopoulos et al. [13] After MS (n = 53) | |
---|---|---|
Age receiving questionnaire | ||
Mean (SD) | 57.6 (13.3) | 49 (–) |
Range | 26–86 | 25–76 |
Mean tumor size (mm) | 17 | 21.5 |
Elapsed time since treatment (years) | Range 0.2–4.6 (mean 1.75) | Range 1–3 |
QOL measured by GBI | ||
Better (%) | 39.4 | 17.4 |
Same (%) | 23.9 | 28.8 |
Worse (%) | 36.7 | 53.8 |