Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study
Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study
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立体定向放射外科确保 Koos IV 级前庭神经鞘瘤的有效和安全的长期控制：一项单中心、回顾性、队列研究
DOI：
10.1007/s11060-022-04058-9
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发表时间：
2022
影响因子：
3.9
通讯作者：
Saito Nobuhito
中科院分区：
文献类型：
--
作者：
Umekawa Motoyuki;Shinya Yuki;Hasegawa Hirotaka;Kawashima Mariko;Shin Masahiro;Katano Atsuto;Minamitani Masanari;Kashio Akinori;Kondo Kenji;Saito Nobuhito
目的立体定向放射外科（SRS）是治疗前庭神经鞘瘤的标准方法。然而，关于较大VSs的肿瘤控制和神经保护的数据缺乏。我们的目的是研究SRS对kos IV级和I-III级VSs的长期疗效。方法纳入1990年至2021年在我院接受SRS治疗的452例VSs患者（50例Koos IV级，402例Koos I-III级）。采用Kaplan-Meier法计算肿瘤控制率和功能保存率，采用log-rank检验进行组间比较。结果srs后中位随访时间为68个月。kos IV级vs5年和10年无进展生存率为91%，kos I-III级vs5年和10年无进展生存率分别为95%和92% （p= 0.278）。在Koos IV级VSs中，面神经和三叉神经的功能保留率在5年时均为96% （Koos I-III级VSs均为98%；面神经，p= 0.410；三叉神经，p= 0.107）。kos IV级vs5年时听力保留率为61%，kos I-III级vs5年时听力保留率为78% （p= 0.645）。有症状的短暂性肿瘤扩张在kos IV级VSs中更为常见（8.0% vs. 2.5%,p= 0.034），尽管所有相关症状都随着肿瘤缩小而减轻。结论srs治疗kos IV级血管性弥漫性病变的效果与kos I-III级血管性病变相当，可达到长期肿瘤控制和神经功能保护的目的。
PurposeStereotactic radiosurgery (SRS) is a standard treatment modality for vestibular schwannomas (VSs). However, there is a paucity of data on tumor control and neurological preservation for larger VSs. We aimed to investigate the long-term effectiveness of SRS for Koos grade IV compared with I-III VSs.MethodsWe included 452 patients with VSs (50 Koos grade IV and 402 Koos grade I‒III) who were treated with SRS at our institution from 1990 to 2021. Tumor control and functional preservation were calculated using the Kaplan–Meier method and compared between groups with the log-rank test.ResultsThe median post-SRS follow-up period was 68 months. Progression-free survival rates were 91% at 5 and 10 years for Koos grade IV VSs, and 95% and 92%, respectively, for Koos grade I‒III VSs (p= 0.278). In Koos grade IV VSs, functional preservation rates of the facial and trigeminal nerves were both 96% at 5 years (both 98% for Koos grade I‒III VSs; facial,p= 0.410; trigeminal,p= 0.107). Hearing preservation rates were 61% at 5 years for Koos grade IV VSs and 78% for Koos grade I–III VSs (p= 0.645). Symptomatic transient tumor expansion was more common with Koos grade IV VSs (8.0% vs. 2.5%,p= 0.034), although all related symptoms diminished in accordance with tumor shrinkage.ConclusionSRS may contribute to long-term tumor control and adequate neurological preservation in the treatment of Koos grade IV VSs, comparable to those in the treatment of Koos grade I‒III VSs.
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影响因子：
4.1
作者：
Chung, Wen-Yuh;Pan, David Hung-Chi;Shih, Yang-Hsin
通讯作者：
Shih, Yang-Hsin
DOI：
10.1016/j.ijrobp.2010.04.019
发表时间：
2011-07-15
影响因子：
7
作者：
Powell, Ceri;Micallef, Caroline;Brada, Michael
通讯作者：
Brada, Michael
影响因子：
2
作者：
Lefranc, Michel;Da Roz, Leila Maria;Regis, Jean
通讯作者：
Regis, Jean
影响因子：
4.8
作者：
Breshears, Jonathan D.;Chang, Joseph;Theodosopoulos, Philip V.
通讯作者：
Theodosopoulos, Philip V.
影响因子：
2.1
作者：
Kawashima, Mariko;Hasegawa, Hirotaka;Saito, Nobuhito
通讯作者：
Saito, Nobuhito