The Relevance of Biologically Effective Dose for Hearing Preservation After Stereotactic Radiosurgery for Vestibular Schwannomas: A Retrospective Longitudinal Study
| Autor: | Tuleasca, C., Toma-Dasu, I., Duroux, S., Starnoni, D., George, M., Maire, R., Daniel, R.T., Patin, D., Schiappacasse, L., Dasu, A., Faouzi, M., Levivier, M. |
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| Rok vydání: | 2023 |
| Předmět: |
Humans
Male Retrospective Studies Neuroma Acoustic/radiotherapy Neuroma Acoustic/surgery Hearing Loss/etiology Hearing Loss/prevention & control Hearing Loss/surgery Longitudinal Studies Radiosurgery/adverse effects Hearing Treatment Outcome Follow-Up Studies Biologically effective dose Cancer och onkologi Vestibular schwannoma Gamma Knife Cancer and Oncology Treatment time Surgery Neurology (clinical) Irradiation time Radiosurgery Stereotactic radiosurgery |
| Zdroj: | Neurosurgery, vol. 92, no. 6, pp. 1216-1226 |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1227/neu.0000000000002352 |
| Popis: | BACKGROUND: Stereotactic radiosurgery has become a common treatment approach for small-to-medium size vestibular schwannomas. OBJECTIVE: To evaluate relationship between time (beam-on and treatment) and risk of hearing decline after stereotactic radiosurgery for vestibular schwannomas in patients with Gardner–Robertson (GR) baseline classes I and II. METHODS: This retrospective longitudinal single-center study included 213 patients with GR I and II treated between June 2010 and December 2019. Risk of passing from GR classes I and II (coded 0) to other classes III, IV, and V (coded 1) and the increase in pure tone average (continuous outcome) were evaluated using a mixed-effect regression model. Biologically effective dose (BED) was further assessed for an alpha/beta ratio of 2.47 (Gy2.47). RESULTS: Binary outcome analysis revealed sex, dose rate, integral dose, time [beam-on time odds ratio 1.03, P = .03, 95% CI 1.00-1.06; treatment time (P = .02) and BED (P = .001) as relevant. Fitted multivariable model included the sex, dose rate, and BED. Pure tone average analysis revealed age, integral dose received by tumor, isocenter number, time (beam-on time odds ratio 0.20, P = .001, 95% CI 0.083-0.33) and BED (P = .005) as relevant. CONCLUSION: Our analysis showed that risk of hearing decline was associated with male sex, higher radiation dose rate (cutoff 2.5 Gy/minute), higher integral dose received by the tumor, higher beam-on time ≥20 minutes, and lower BED. A BED between 55 and 61 was considered as optimal for hearing preservation. De tre sista författarna delar sistaförfattarskapet |
| Databáze: | OpenAIRE |
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