Long-term outcome after highly advanced single-dose or fractionated radiotherapy in patients with vestibular schwannomas – Pooled results from 3 large German centers

Combs, Stephanie E.; Engelhard, Christina; Kopp, Claire B.; Wiedenmann, Nicole; Schramm, Oliver; Prokic, V.; Debus, Jürgen; Molls, M.; Grosu, Anca‐Ligia

doi:10.1016/j.radonc.2015.01.011

Cited by 79 publications

(67 citation statements)

References 56 publications

(125 reference statements)

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“…27 A recent German study evaluated the long term clinical outcome in 451 VS treated with SRS (n = 169, median dose 13 Gy) or FSRT (n = 291, 57.6 Gy in median single doses of 1.8 Gy). 28 After a median follow-up of 67 months, local control rate was 97% at 36 months, 95% at 60 months, and 94% at 120 months, with no difference between FSRT and SRS (p = 0.39). Loss of useful hearing was observed in 14% of the FSRT group and in 16% of the SRS group.…”

Section: Srs and Fsrt: Compared Schedulesmentioning

confidence: 85%

“…28,40,42 Preservation of serviceable hearing is reported to be higher after radiotherapy (30-98%) 13,24,28 than after surgery (30-50%). 28,40,42 In particular, the metanalysis from Maniakas et al 2 confirmed that the results of microsurgery and SRS are comparable in terms of local control but SRS can better preserve hearing function and a systematic review of controlled studies showed that SRS for VS of less than 3 cm in diameter can be the treatment of choice. 5 A recent long-term study confirmed the usefulness of the initial wait and see policy in the small VS and a better quality of life in the patients treated by SRS rather than microsurgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Radiotherapy for vestibular schwannoma: Review of recent literature results

Apicella

Paolini

Deantonio

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Section: Srs and Fsrt: Compared Schedulesmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Radiotherapy for vestibular schwannoma: Review of recent literature results

Apicella

Paolini

Deantonio

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…In our study, 7 patients were treated by CyberKnife in three sessions of 6.5 Gy vs 39 by GammaKnife in a single session of 12 Gy and there was no difference between tumour control and hearing between these two treatments. A study of Combs et al found that local control of VS was 97% at 36 months, 95% at 60 months and 94% at 120 months with no difference between fractionated dose or single dose of RT ( P = 0.39). After RT, hearing preservation was observed in 85% of the patients.…”

Section: Discussionmentioning

confidence: 97%

Quality of life in the management of small vestibular schwannomas: Observation, radiotherapy and microsurgery

Deberge

Meyer

Pabic

et al. 2018

Clinical Otolaryngology

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“…Single-dose stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) aiming to arrest tumor growth are the most commonly used noninvasive alternatives. In case series of patients suitable for radiosurgery/radiotherapy, the progression-free survival rates are comparable to those of case series of microsurgical resection of VS [14, 16, 30, 53]. Further, controlled studies and subsequent systematic reviews support the use of radiosurgery in VS patients eligible for both surgery and radiosurgery [23, 36, 38, 42, 43, 46].…”

Section: Introductionmentioning

confidence: 86%

Stereotactic radiosurgery vs. fractionated radiotherapy for tumor control in vestibular schwannoma patients: a systematic review

et al. 2017

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ObjectiveRepeated controlled studies have revealed that stereotactic radiosurgery is better than microsurgery for patients with vestibular schwannoma (VS) <3 cm in need of intervention. In this systematic review we aimed to compare results from single-fraction stereotactic radiosurgery (SRS) to fractionated stereotactic radiotherapy (FSRT) for patients with VS.Data sources and eligibility criteriaWe systematically searched MEDLINE, Web of Science, Embase and Cochrane and screened relevant articles for references. Publications from 1995 through 2014 with a minimum of 50 adult (>18 years) patients with unilateral VS, followed for a median of >5 years, were eligible for inclusion. After screening titles and abstracts of the 1094 identified articles and systematically reviewing 98 of these articles, 19 were included.InterventionPatients with unilateral VS treated with radiosurgery were compared to patients treated with fractionated stereotactic radiotherapy.ResultsNo randomized controlled trial (RCT) was identified. None of the identified controlled studies comparing SRS with FSRT were eligible according to the inclusion criteria. Nineteen case series on SRS (n = 17) and FSRT (n = 2) were included in the systematic review. Loss of tumor control necessitating a new VS-targeted intervention was found in an average of 5.0% of the patients treated with SRS and in 4.8% treated with FSRT. Mean deterioration ratio for patients with serviceable hearing before treatment was 49% for SRS and 45% for FSRT, respectively. The risk for facial nerve deterioration was 3.6% for SRS and 11.2% for FSRT and for trigeminal nerve deterioration 6.0% for SRS and 8.4% for FSRT. Since these results were obtained from case series, a regular meta-analysis was not attempted.ConclusionSRS and FSRT are both noninvasive treatment alternatives for patients with VS with low rates of treatment failure in need of rescue therapy. In this selection of patients, the progression-free survival rates were on the order of 92–100% for both treatment options. There is a lack of high-quality studies comparing radiation therapy alternatives for patients with VS. Finally, 19 articles reported long-term tumor control after SRS, while only 2 articles reported long-term FSRT results, making effect estimates more uncertain for FSRT.Electronic supplementary materialThe online version of this article (doi:10.1007/s00701-017-3164-6) contains supplementary material, which is available to authorized users.

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Long-term outcome after highly advanced single-dose or fractionated radiotherapy in patients with vestibular schwannomas – Pooled results from 3 large German centers

Cited by 79 publications

References 56 publications

Radiotherapy for vestibular schwannoma: Review of recent literature results

Radiotherapy for vestibular schwannoma: Review of recent literature results

Quality of life in the management of small vestibular schwannomas: Observation, radiotherapy and microsurgery

Stereotactic radiosurgery vs. fractionated radiotherapy for tumor control in vestibular schwannoma patients: a systematic review

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