TY - JOUR
T1 - Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in young patients
T2 - a multi-institutional study
AU - Dumot, Chloe
AU - Pikis, Stylianos
AU - Mantziaris, Georgios
AU - Xu, Zhiyuan
AU - Anand, Rithika Kormath
AU - Nabeel, Ahmed M.
AU - Sheehan, Darrah
AU - Sheehan, Kimball
AU - Reda, Wael A.
AU - Tawadros, Sameh R.
AU - Abdel Karim, Khaled
AU - El-Shehaby, Amr M.N.
AU - Emad Eldin, Reem M.
AU - Peker, Selcuk
AU - Samanci, Yavuz
AU - Kaisman-Elbaz, Tehila
AU - Speckter, Herwin
AU - Hernández, Wenceslao
AU - Isidor, Julio
AU - Tripathi, Manjul
AU - Madan, Renu
AU - Zacharia, Brad E.
AU - Daggubati, Lekhaj C.
AU - Moreno, Nuria Martínez
AU - Álvarez, Roberto Martínez
AU - Langlois, Anne Marie
AU - Mathieu, David
AU - Deibert, Christopher P.
AU - Sudhakar, Vivek R.
AU - Cifarelli, Christopher P.
AU - Icaza, Denisse Arteaga
AU - Cifarelli, Daniel T.
AU - Wei, Zhishuo
AU - Niranjan, Ajay
AU - Barnett, Gene H.
AU - Lunsford, L. Dade
AU - Bowden, Greg N.
AU - Sheehan, Jason P.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Purpose: Surgery is the treatment of choice for large vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has been suggested as an alternative to resection in selected patients. However, the safety and efficacy of SRS in Koos grade IV patients ≤ 45 years old has not been evaluated. The aim of this study is to describe the clinical and radiological outcomes of Koos grade IV in young patient managed with a single-session SRS. Methods: This retrospective, multicenter analysis included SRS-treated patients, ≤ 45 years old presenting with non-life threatening or incapacitating symptoms due to a Koos Grade IV VS and with follow-up ≥ 12 months. Tumor control and neurological outcomes were evaluated. Results: 176 patients [median age of 36.0 (IQR 9) and median tumor volume of 9.3 cm3 (IQR 4.7)] were included. The median prescription dose was 12 Gy (IQR 0.5). Median follow-up period was 37.5 (IQR 53.5) months. The 5- and 10-year progression-free survival was 90.9% and 86.7%. Early tumor enlargement occurred in 10.9% of cases and was associated with tumor progression at the last follow-up. The probability of serviceable hearing preservation at 5- and 10-years was 56.8% and 45.2%, respectively. The probability of improvement or preservation of facial nerve function was 95.7% at 5 and 10-years. Adverse radiation effects were noted in 19.9%. New-onset hydrocephalus occurred in 4.0%. Conclusion: Single-session SRS is a safe and effective alternative to surgical resection in selected patients ≤ 45 years old particularly those with medical co-morbidities and those who decline resection. Longer term follow up is warranted.
AB - Purpose: Surgery is the treatment of choice for large vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has been suggested as an alternative to resection in selected patients. However, the safety and efficacy of SRS in Koos grade IV patients ≤ 45 years old has not been evaluated. The aim of this study is to describe the clinical and radiological outcomes of Koos grade IV in young patient managed with a single-session SRS. Methods: This retrospective, multicenter analysis included SRS-treated patients, ≤ 45 years old presenting with non-life threatening or incapacitating symptoms due to a Koos Grade IV VS and with follow-up ≥ 12 months. Tumor control and neurological outcomes were evaluated. Results: 176 patients [median age of 36.0 (IQR 9) and median tumor volume of 9.3 cm3 (IQR 4.7)] were included. The median prescription dose was 12 Gy (IQR 0.5). Median follow-up period was 37.5 (IQR 53.5) months. The 5- and 10-year progression-free survival was 90.9% and 86.7%. Early tumor enlargement occurred in 10.9% of cases and was associated with tumor progression at the last follow-up. The probability of serviceable hearing preservation at 5- and 10-years was 56.8% and 45.2%, respectively. The probability of improvement or preservation of facial nerve function was 95.7% at 5 and 10-years. Adverse radiation effects were noted in 19.9%. New-onset hydrocephalus occurred in 4.0%. Conclusion: Single-session SRS is a safe and effective alternative to surgical resection in selected patients ≤ 45 years old particularly those with medical co-morbidities and those who decline resection. Longer term follow up is warranted.
KW - Koos grade IV
KW - Stereotactic radiosurgery
KW - Vestibular schwannoma
KW - Young age
UR - http://www.scopus.com/inward/record.url?scp=85138867728&partnerID=8YFLogxK
U2 - 10.1007/s11060-022-04134-0
DO - 10.1007/s11060-022-04134-0
M3 - Article
C2 - 36166113
AN - SCOPUS:85138867728
SN - 0167-594X
VL - 160
SP - 201
EP - 208
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -
