Long-term outcomes of rotating gamma knife for vestibular schwannoma: A 4-year prospective longitudinal study of 89 consecutive patients in Vietnam.

Autor:	Kieu HD; Department of Neurosurgery and Spine Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam., Vuong DN; The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam., Mai KT; The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam., Pham PC; The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam., Le TD; Department of Neurosurgery and Spine Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2021 Nov 30; Vol. 12, pp. 585. Date of Electronic Publication: 2021 Nov 30 (Print Publication: 2021).
DOI:	10.25259/SNI_687_2021
Abstrakt:	Background: Microsurgical total removal of vestibular schwannoma (VS) is the definitive treatment but has a high incidence of postoperative neurological deficits. Rotating Gamma Knife (RGK) is a preferred option for a small tumor. This study aims to evaluate long-term neurological outcomes of RGK for VS. Methods: This prospective longitudinal study was conducted at the Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam. Eighty-nine consecutive patients were enrolled from October 2011 to October 2015 and followed up to June 2017. RGK was indicated for VS measuring <2.2 cm, while RGK for tumors measuring 2.2-3 cm was considered in patients with severe comorbidities, high-risk surgery, and who denied surgery. Concurrently, VS consisted of newly diagnosed, postoperative residual, and recurrent tumors. Patients with neurofibromatosis type 2 were excluded from the study. Primary outcomes were radiological tumor control rate, vestibulocochlear functions, facial and trigeminal nerve preservation. Stereotactic radiosurgery was performed by the Rotating Gamma System Gamma ART 6000. Results: The tumors were measured 20.7 ± 5.6 mm at pre treatment and 17.6 ± 4.1 mm at 3-year post treatment. The mean radiation dose was 13.5 ± 0.9 Gy. Mean follow-up was 40.6 ± 13.3 months. The radiological tumor control rate was achieved 95.5% at 5-year post treatment. The hearing and vestibular functions were preserved in 70.3% and 68.9%, respectively. The facial and trigeminal nerve preservation rates were 94.4% and 73.3%, respectively. Conclusion: RGK is an effective and safe treatment for VS measuring ≤3 cm with no significant complications during long-term follow-up. Competing Interests: There are no conflicts of interest. (Copyright: © 2021 Surgical Neurology International.)
Databáze:	MEDLINE
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