Cochlear radiation dose and hearing loss in patients with vestibular schwannoma undergoing radiosurgery: systematic review

Cavalcanti, Gabriela Silva Teixeira; Lemos, Andrea; Moretti, Eduarda C.; Lucena, Camilla Maria G.A.; Gomes, João Gabriel R.; Muniz, Lílian F.; Venâncio, Leonardo G.A.; Caldas, Silvio; Leal, Mariana C.

doi:10.1016/j.bjorl.2023.101300

Cited by 1 publication

(1 citation statement)

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“…Although some authors have asserted a strong connection between SRS treatment parameters such as cochlear dose and hearing loss after SRS, this remains controversial and is not uniformly considered in treatment planning. Therefore, associations between cochlear dose and hearing loss in the repeat SRS setting were not examined (42,43).…”

Section: Discussionmentioning

confidence: 99%

Repeat Radiosurgery for Sporadic Vestibular Schwannoma After Primary Radiosurgical Failure: An International Multi-institutional Investigation

Khandalavala,

Herberg,

Kay-Rivest

et al. 2024

Otol Neurotol

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Objective To describe outcomes of patients with sporadic vestibular schwannoma (VS) who underwent repeat stereotactic radiosurgery (SRS) after primary SRS failure. Study Design Multi-institutional historical cohort study. Setting Five tertiary care referral centers. Patients Adults ≥18 years old with sporadic VS. Intervention Primary and repeat treatment with SRS. Main Outcome Measure Microsurgery-free survival after repeat SRS. Results Across institutions, 32 patients underwent repeat SRS after primary SRS. Most patients (74%) had tumors with cerebellopontine angle extension at primary SRS (median size, 13.5 mm [interquartile range, 7.5–18.8] mm). After primary SRS, patients underwent repeat SRS at a median of 4.8 years (interquartile range, 3.2–5.7 yr). For treatment modality, 30 (94%) patients received gamma knife for primary treatment and 31 (97%) patients received gamma knife as their repeat treatment. Median tumor volume increased from 0.970 cm3 at primary SRS to 2.200 cm3 at repeat SRS. Facial nerve function worsened in two patients after primary SRS and in two patients after repeat SRS. There were no instances of intracranial complications after repeat SRS. Microsurgery-free survival rates (95% confidence interval; number still at risk) at 1, 3, and 5 years after repeat SRS were 97% (90–100%, 24), 84% (71–100%, 13), and 68% (48–96%, 6), respectively. There was one occurrence of malignancy diagnosed after repeat radiosurgery. Conclusion Overall, repeat SRS for sporadic VS has comparable risk profile, but lower rates of tumor control, compared with primary SRS.

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Section: Discussionmentioning

confidence: 99%