Stereotactic Radiosurgery in Primary Treatment of Sporadic Small to Medium (<3 cm) Vestibular Schwannomas: A Systematic Review and Meta-Analysis.

Autor: Bonin BJ; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Beckman S; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Mahmud S; Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh., Terrell D; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Whipple SG; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Diaz R; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Nobel Bhuiyan MA; Department of Internal Medicine at Louisiana State University Health Science Center, Shreveport, Louisiana., Kumbhare D; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Wang CJ; Department of Radiation Oncology Willis-Knighton Cancer Center, Shreveport, Louisiana., Guthikonda B; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana., Savardekar AR; Department of Neurosurgery at Louisiana State University Health Sciences Center, Shreveport, Louisiana. Electronic address: amey.savardekar@lsuhs.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Oct 24. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1016/j.wneu.2024.10.033
Abstrakt: Purpose: To analyze the current literature regarding use of SRS as primary treatment of VS to further evaluate efficacy and treatment-related neurologic deficits.
Methods: Online databases were queried to identify relevant publications from January 2001-December 2020. Full text, English articles for sporadic VS treated primarily with radiosurgery and documented hearing preservation data were reviewed. Papers that had a minimum follow-up period of less than 36 months, did not utilize radiosurgery for primary treatment, or included patients with Neurofibromatosis II were excluded.
Results: A total of 33 studies involving 4286 patients with an average follow-up of 62.5 months were included in the final analysis. All 33 studies included eligible hearing data; overall preservation of serviceable hearing was found to be 58.27%. 27 studies with 3822 eligible patients were analyzed for tumor control rates; overall, tumor control was reported in 92.98% of cases. 27 studies were analyzed for post-treatment facial nerve dysfunction which was reported in 1.53% of cases.
Conclusions: SRS is a safe and effective primary treatment modality for sporadic vestibular schwannoma as evidenced by the present analysis. Radiosurgery is effective with regard to tumor control and hearing preservation while offering a low rate of post-treatment facial nerve dysfunction.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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