Stereotactic Radiosurgery for Vestibular Schwannoma Outcomes in Patients With Perfect Word Recognition-A Retrospective Cohort Study.
Otol Neurotol
; 42(5): 755-764, 2021 06 01.
Article
em En
| MEDLINE
| ID: mdl-33443977
ABSTRACT
OBJECTIVES:
To investigate tumor control rate and hearing outcomes following stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) cases with perfect (100%) word recognition score (WRS). STUDYDESIGN:
A retrospective cohort study.SETTING:
Tertiary referral center. PATIENTS Inclusion criteria were receiving primary SRS, a pretreatment WRS of 100%, and availability of both pre- and posttreatment audiometric data for evaluation. INTERVENTION SRS delivered by Cyberknife. MAIN OUTCOMEMEASURES:
Tumor growth rates and audiological outcomes after SRS.RESULTS:
The cohort consisted of 139 patients, with more than 1-year follow-up (mean 6.1 yrs). SRS tumor control rate was 87% for the whole cohort. Growth before SRS was documented in 24% (nâ=â34 of 139). The proportion of sporadic VS cases who maintained hearing (decline <10âdB of pure-tone audiometry or <20% of WRS) at 3 years was 50%, at 5 years was 45%, and at 10 years was 42%. In multivariate analysis, increased age was found to be predictive of increased hearing loss (pâ=â0.03), while the following factors were shown not to be significant sex (pâ=â0.5), tumor size (pâ=â0.2), pre-SRS tumor growth (pâ=â0.5), and target volume (pâ=â0.42).CONCLUSIONS:
Among patients with VS who had perfect WRS and underwent SRS, the overall tumor control rate was 87% comparable to observation. Hearing maintenance and preservation of "serviceable" hearing rates after 5 years in VS patients with perfect WRS treated by SRS is less than that when comparing to similar observation cohorts. Given this finding we do not advocate using SRS to preserve hearing, over observation, in tumors with perfect WRS.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neuroma Acústico
/
Radiocirurgia
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Otol Neurotol
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos