Assessment of Tumor Volume Dynamics and Outcome After Radiosurgery for the Treatment of Vestibular Schwannoma: A Single-Center Experience.

Ermis, Ekin; Egger, Riccarda; Leiser, Dominic; Anschütz, Lukas; Raabe, Andreas; Abu-Isa, Janine; Manser, Peter; Aebersold, Daniel M.; Wagner, Franca; Herrmann, Evelyn (2021). Assessment of Tumor Volume Dynamics and Outcome After Radiosurgery for the Treatment of Vestibular Schwannoma: A Single-Center Experience. Otology & neurotology, 42(6), e750-e757. Wolters Kluwer 10.1097/MAO.0000000000003056

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OBJECTIVE

To assess the factors affecting early local and audiometric outcomes in vestibular schwannoma (VS) patients treated with stereotactic radiosurgery (SRS).

STUDY DESIGN

A retrospective review of medical records.

SETTING

Tertiary referral center.

PATIENTS

Records of all adult patients who underwent SRS between 2010 and 2016 for the treatment of VS were retrospectively reviewed. Patients treated with microsurgery or multi-fractionation schemes, and those who had neurofibromatosis type 2, were excluded.

INTERVENTION

SRS, tumor volume/size measurements.

MAIN OUTCOME MEASURES

The impact of tumor volume dynamics on the early local and hearing-related outcomes, together with the factors that influence them following SRS, and comparison of different tumor size measurement methods.

RESULTS

From 2010 to 2016, 53 patients underwent single fraction SRS of 12 Gy. Median follow-up time was 32 months (range, 6-79). At the last follow-up, only one patient had clinical progression. Age less than or equal to 65 years (p = 0.04; odds ratio [OR]: 0.17; 95% confidence interval [CI]: 0.03-0.93) and baseline pure-tone average (PTA) level less than or equal to 30 dB (p = 0.03; OR: 0.90; 95% CI: 0.84-0.96) were associated with maintenance of serviceable hearing. On multivariate analysis, PTA remained significant (p = 0.01; OR: 0.04; 95% CI: 0.003-0.45). In patients with a loss of serviceable hearing, the mean volume increase tended to be higher than in the patients whose hearing was maintained. The linear measurement method underestimated, and the A × B × C/2 equation overestimated, the radiological progression compared with 3D-volumetric delineations.

CONCLUSION

During the median observation period of almost 3 years, we reported our early outcome results. Tumor volume increase may have an impact on serviceable hearing loss after SRS. Currently there is no widely accepted method for the evaluation of post-SRS response. Linear measurement and the A × B × C/2 equation produce less reliable estimates of radiological progression compared with 3D-volumetric delineations. Accurate volume measurements with 3D delineations should be considered as part of clinical routine for assessing progression and deciding on salvage therapies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology > Medical Radiation Physics
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Ermis, Ekin; Leiser, Dominic; Anschütz, Lukas Peter; Raabe, Andreas; Abu-Isa, Janine; Manser, Peter; Aebersold, Daniel; Wagner, Franca and Herrmann, Evelyn

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1537-4505

Publisher:

Wolters Kluwer

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

22 Jun 2021 13:59

Last Modified:

22 Jun 2021 14:05

Publisher DOI:

10.1097/MAO.0000000000003056

PubMed ID:

34111052

BORIS DOI:

10.48350/156896

URI:

https://boris.unibe.ch/id/eprint/156896

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