Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Phi, Ji Hoon; Kim, Dong Gyu; Chung, Hyun Tai; Lee, Joongyub; Paek, Sun Ha; Jung, Hee Won

doi:10.1002/cncr.24036

Cited by 76 publications

(61 citation statements)

References 42 publications

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“…This is also associated with reduced recurrence of the tumor in one the study by decreasing the volume of tumor by 33%. [71,72]. Although a number of complications have also been reported with surgical removal of the VS including air embolism, ICH, Ischemic stroke in the first 3 days of surgery.…”

Section: Treatmentmentioning

confidence: 99%

Phakomatoses and Their Tumors: Genetics and New Treatment Options

Malik¹,

Majeed²,

Turner³

2017

New Approaches to the Management of Primary and Secondary CNS Tumors

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In addition to sporadic primary neoplasms of the central nervous system, several genetic syndromes associated with CNS tumors have been identified. Tuberous sclerosis, neurofibromatosis-1 and -2, and von Hippel-Lindau syndrome belong to a collection of disorders called phakomatoses, which include both CNS tumors and cutaneous manifestations. The underlying genetics of these disorders are being elucidated and offer novel therapies for intervention.

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Section: Treatmentmentioning

confidence: 99%

Phakomatoses and Their Tumors: Genetics and New Treatment Options

Malik¹,

Majeed²,

Turner³

2017

New Approaches to the Management of Primary and Secondary CNS Tumors

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“…However, the usefulness of GKS for VSs in NF2 patients is well known to be much less effective than in patients with sporadic VS. 10,11,32 Nevertheless, some reports have presented relatively good outcomes of GKS if the VSs in NF2 patients are detected and treated early. 20,28,31 In many previous studies, the tumor control rate and hearing preservation rate of NF2-related VSs after GKS has been reported to range from 66% to 85% and from 33% to 48%, respectively. 20,28,32 However, there has been no report about GKS outcomes of VSs in children with NF2.…”

Section: Vestibular Schwannoma In Children With Nf2mentioning

confidence: 99%

“…20,28,31 In many previous studies, the tumor control rate and hearing preservation rate of NF2-related VSs after GKS has been reported to range from 66% to 85% and from 33% to 48%, respectively. 20,28,32 However, there has been no report about GKS outcomes of VSs in children with NF2. Our series showed a hearing preservation rate after GKS that was similar to previous reports of all age groups (67% in the 1st year and 53% in the 5th year after GKS); however, the tumor control rate after was somewhat unsatisfactory GKS (35.3% at 3 years after GKS).…”

Section: Vestibular Schwannoma In Children With Nf2mentioning

confidence: 99%

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Clinical course of vestibular schwannoma in pediatric neurofibromatosis Type 2

Choi

Lee

Wang

et al. 2014

PED

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Object Neurofibromatosis Type 2 (NF2) is an autosomal-dominant inherited disease, characterized by multiple neoplasia syndromes, including meningioma, schwannoma, glioma, and ependymoma. In this report, the authors present their clinical experience with pediatric NF2 patients. In particular, they focused on the clinical course of vestibular schwannoma (VS), including the natural growth rate, tumor control, and functional hearing outcomes. Methods From May 1988 to June 2012, the authors recruited patients who were younger than 18 years and fulfilled the Manchester criteria. In total, 25 patients were enrolled in this study. The authors analyzed the clinical course of these patients. In addition, they measured the natural growth rate of VS before any treatment in these children with NF2. Then, they evaluated the tumor control rate and functional hearing outcomes after the treatment of VS. Results The mean age at the onset of NF2-related symptoms was 9.9 ± 4.5 years (mean ± SD, range 1–17 years). The mean age at the diagnosis of NF2 was 12.9 ± 2.9 years (range 5–17 years). The mean follow-up period was 89.3 months (range 12–311 months). As initial manifestations, nonvestibular symptoms were frequently observed in pediatric patients with NF2. The mean natural growth rate of VS was 0.33 ± 0.41 cm3/year (range 0–1.35 cm3/year). The tumor control rate of VS was 35.3% at 3 years after Gamma Knife surgery (GKS). The actuarial rate of useful hearing preservation was 67% in the 1st year and 53% in the 5th year after GKS. Conclusions Clinical manifestations in children with NF2 were highly variable, compared with their adult counterparts. The natural growth rate of VS in children is slow, and this oncological feature may explain the diverse clinical manifestations besides vestibular symptoms in children with NF2. The treatment outcome of GKS for VS in children with NF2 was not favorable compared with previous reports of affected adults.

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“…Five-year progression-free survival rates were 66% to 85% and hearing preservation rates were 33% to 48% after stereotactic radiosurgery for neurofibromatosis type 2 patients. 82,101) Gamma knife radiosurgery is also widely accepted for the treatment of pituitary adenomas, mainly in combination with surgical removal. Tumor control rates for nonfunctioning pituitary adenomas were 87% to 97%, and the rates of new hormone deficit were 6.5% to 25% by application of margin doses of 14 to 18.5 Gy.…”

Section: Benign Tumorsmentioning

confidence: 99%

Role of Gamma Knife Radiosurgery in Neurosurgery: Past and Future Perspectives

Koga

Shin

Saito

2010

Neurol. Med. Chir.(Tokyo)

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The gamma knife was the first radiosurgical device developed at the Karolinska Institute in 1967. Stereotactic radiosurgery using the gamma knife has been widely accepted in clinical practice and has contributed to the development of neurosurgery. More than 500,000 patients have been treated by gamma knife stereotactic radiosurgery so far, and the method is now an indispensable neurosurgical tool. Here we review long-term outcomes and development of stereotactic radiosurgery using the gamma knife and discuss its future perspectives. The primary role of stereotactic radiosurgery is to control small well-demarcated lesions such as metastatic brain tumors, meningiomas, schwannomas, and pituitary adenomas while preserving the function of surrounding brain tissue. The gamma knife has been used as a primary treatment or in combination with surgery, and some applications have been accepted as standard treatment in the field of neurosurgery. Treatment of cerebral arteriovenous malformations has also been drastically changed after emergence of this technology. Controlling functional disorders is another role of stereotactic radiosurgery. There is a risk of radiation-induced adverse events, which are usually mild and less frequent. However, especially in large or invasive lesions, those risks are not negligible and pose limitations. Advancement of irradiation technology and dose planning software have enabled more sophisticated and safer treatment, and further progress will contribute to better treatment outcomes not only for brain lesions but also for cervical lesions with less invasive treatment.

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Radiosurgical treatment of vestibular schwannomas in patients with neurofibromatosis type 2

Cited by 76 publications

References 42 publications

Phakomatoses and Their Tumors: Genetics and New Treatment Options

Phakomatoses and Their Tumors: Genetics and New Treatment Options

Clinical course of vestibular schwannoma in pediatric neurofibromatosis Type 2

Role of Gamma Knife Radiosurgery in Neurosurgery: Past and Future Perspectives

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