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Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study.
Chang, Steven D; Muacevic, Alexander; Klein, Andrea L; Sherman, Jonathan H; Romanelli, Pantaleo; Santa Maria, Peter L; Fuerweger, Christoph; Bossi Zanetti, Isa; Beltramo, Giancarlo; Vaisbush, Yona; Tran, Emma; Feng, Austin; Teng, Hao; Meola, Antonio; Gibbs, Iris; Tolisano, Antony M; Kutz, Joe Walter; Wardak, Zabi; Nedzi, Lucien A; Hong, Robert; MacRae, Don; Sohal, Preet; Kapoor, Elina; Sabet-Rasekh, Parisa; Maghami, Sam; Moncada, Paola X; Zaleski-King, Ashley; Amdur, Richard; Monfared, Ashkan.
Afiliação
  • Chang SD; Department of Neurosurgery, Stanford University, Stanford, California, USA.
  • Muacevic A; European Cyberknife Center, Munich, Germany.
  • Klein AL; The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: andreaklein@gwu.edu.
  • Sherman JH; Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.
  • Romanelli P; Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.
  • Santa Maria PL; Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California, USA.
  • Fuerweger C; European Cyberknife Center, Munich, Germany.
  • Bossi Zanetti I; Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.
  • Beltramo G; Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.
  • Vaisbush Y; Technion, Haifa, Israel.
  • Tran E; Stanford University School of Medicine, Stanford, California, USA.
  • Feng A; Stanford University School of Medicine, Stanford, California, USA.
  • Teng H; Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
  • Meola A; Department of Neurosurgery, Stanford University, Stanford, California, USA.
  • Gibbs I; Department of Radiation Oncology, Stanford University, Stanford, California, USA.
  • Tolisano AM; Department of Otolaryngology, Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
  • Kutz JW; Department of Otolaryngology and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Wardak Z; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Nedzi LA; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Hong R; Virginia Hospital Center, Arlington, Virginia, USA.
  • MacRae D; Virginia Hospital Center, Arlington, Virginia, USA.
  • Sohal P; The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Kapoor E; The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Sabet-Rasekh P; Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Maghami S; Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Moncada PX; Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Zaleski-King A; Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Amdur R; Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
  • Monfared A; Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Neurosurgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
World Neurosurg ; 178: e24-e33, 2023 Oct.
Article em En | MEDLINE | ID: mdl-37268187
ABSTRACT

OBJECTIVE:

Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration.

METHODS:

Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990-2020 and had pre- and post-treatment audiograms.

RESULTS:

Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12-60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS.

CONCLUSIONS:

Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuroma Acústico / Radiocirurgia Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuroma Acústico / Radiocirurgia Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article