Stereotactic Radiosurgery for Vestibular Schwannoma in Neurofibromatosis Type 2: An International Multicenter Case Series of Response and Malignant Transformation Risk.
Neurosurgery
; 92(5): 934-944, 2023 05 01.
Article
en En
| MEDLINE
| ID: mdl-36861994
ABSTRACT
BACKGROUND:
Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety.OBJECTIVE:
To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS.METHODS:
We performed a retrospective study of 267 patients with NF2 (328 VSs) who underwent single-session SRS at 12 centers participating in the International Radiosurgery Research Foundation. The median patient age was 31 years (IQR, 21-45 years), and 52% were male.RESULTS:
A total of 328 tumors underwent SRS during a median follow-up time of 59 months (IQR, 23-112 months). At 10 and 15 years, the tumor control rates were 77% (95% CI 69%-84%) and 52% (95% CI 40%-64%), respectively, and the FFAT rate were 85% (95% CI 79%-90%) and 75% (95% CI 65%-86%), respectively. At 5 and 10 years, the serviceable hearing preservation rates were 64% (95% CI 55%-75%) and 35% (95% CI 25%-54%), respectively. In the multivariate analysis, age (hazards ratio 1.03 [95% CI 1.01-1.05]; P = .02) and bilateral VSs (hazards ratio 4.56 [95% CI 1.05-19.78]; P = .04) were predictors for serviceable hearing loss. Neither radiation-induced tumors nor malignant transformation were encountered in this cohort.CONCLUSION:
Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neuroma Acústico
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Radiocirugia
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Neurofibromatosis 2
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Pérdida Auditiva
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurosurgery
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos