Evaluation of tumour response after gamma knife radiosurgery for residual vestibular schwannomas based on MRI morphological features

Yang, Seung Man; Kim, Dong Gyu; Chung, Hyun‐Tai; Park, Sung Sup; Paek, Sun Ha; Jung, Hee-Won

doi:10.1136/jnnp.2007.119602

Cited by 49 publications

(33 citation statements)

References 23 publications

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“…Our experience supports the concept reported in the literature that a combined treatment regimen provides both sufficient local tumor control and excellent preservation of facial nerve function [11,12,13,14,15,16,17,20,21]. Although the extent of the influence of tumor removal on postoperative facial nerve function remains controversial, the conclusion that reduced intraoperative mechanical stress during STR might help maintain neural function appears feasible.…”

Section: Discussionsupporting

confidence: 75%

“…The debate continues over complete versus incomplete removal as the best management strategy for patients with VS. To date, there have only been a few studies involving a limited number of patients in which outcomes of subtotal removal followed by adjuvant radiosurgery in the treatment of large VS have been analyzed [11,12,13,14,15,16,17]. In the present study, we achieved a 100% tumor control rate, with 87% of our patients showing excellent facial nerve function in the follow-up.…”

Section: Discussionsupporting

confidence: 56%

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Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Radwan

Eisenberg²,

Knisely³

et al. 2016

Stereotact Funct Neurosurg

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Background: The debate continues with a limited number of publications describing outcomes in patients with vestibular schwannoma (VS) treated with planned subtotal resection (STR) plus stereotactic radiosurgery (SRS). Here we present our experience. Methods: This is a retrospective review of 22 patients with VS Koos grade III and IV who were treated with STR followed by SRS. Tumor volumes, facial nerve function, hearing preservation, and the presence of trigeminal neuropathy were noted. Spearman's rank test was used to correlate facial nerve grade with postoperative tumor residual tumor volume. Results: Tumor control was achieved in all patients with a mean follow-up of 28 months. No patient required other treatment beyond the original surgery and adjuvant SRS during this period. After a mean postoperative period of 28 months, 19/22 patients had excellent (House-Brackmann I or II) facial nerve function grading. Improved facial nerve function was positively correlated with larger residual tumor volume (r_s = 0.63). Kaplan-Meier curve showed around 80% probability for regaining facial nerve function after initial deterioration. Four patients reported postoperative facial numbness at the side of surgery, with 3 cases showing improvement within a month. Temporary postoperative caudal cranial nerve dysfunction was observed in 2 patients. Conclusion: Hybrid strategy of STR and adjuvant SRS provides patients with large VS excellent tumor control and a good clinical outcome.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 56%

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Radwan

Eisenberg²,

Knisely³

et al. 2016

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…For ANs, Meijer et al [22] reported mean TV shrinkage of 49% in a series of 45 patients treated with SRS. Yang et al [28] reported a mean tumor half-reduction time of 8.7 years after SRS in a series of 61 patients. TV changes were also measured with a 3-D volumetric technique.…”

Section: Tumor Volume Shrinkagementioning

confidence: 99%

“…In the literature, no determinant factors are known that affect TV shrinkage of ANs after SRS/SRT. Authors using a 3-D volumetric technique [22,28] did not find any determinant factor for TV shrinkage after SRS in their series either. Indeed, in multivariate analysis, a smaller TV was reported to be a predictor of LC and progression-free survival after SRS, respectively.…”

Section: Determinant Factorsmentioning

confidence: 99%

Comparison of Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy of Acoustic Neurinomas According to 3-D Tumor Volume Shrinkage and Quality of Life

et al. 2009

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“…Although some clinicians advocate planned stereotactic radiation for incompletely resected large tumors, we do not. [41][42][43][44][45] Given the low need for retreatment seen earlier, it is our belief that, when a true subtotal or near-total resection is performed, the decreased vascularity of the tumor results in a low likelihood of tumor growth.…”

Section: Surgerymentioning

confidence: 97%

Historical Perspective on Evolution in Management of Lateral Skull Base Tumors

McRackan

Brackmann

2015

Otolaryngologic Clinics of North America

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Evaluation of tumour response after gamma knife radiosurgery for residual vestibular schwannomas based on MRI morphological features

Cited by 49 publications

References 23 publications

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Outcomes in Patients with Vestibular Schwannoma after Subtotal Resection and Adjuvant Radiosurgery

Comparison of Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy of Acoustic Neurinomas According to 3-D Tumor Volume Shrinkage and Quality of Life

Historical Perspective on Evolution in Management of Lateral Skull Base Tumors

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