Stereotactic Radiosurgery for Vestibular Schwannoma in Neurofibromatosis Type 2: An International Multicenter Case Series of Response and Malignant Transformation Risk

被引：13

作者：

Bin-Alamer, Othman ^{[1
]}

Faramand, Andrew ^{[1
]}

Alarifi, Norah A. ^{[1
,3
]}

Wei, Zhishuo ^{[1
]}

Mallela, Arka N. ^{[1
]}

Lu, Victor M. ^{[4
]}

Nabeel, Ahmed M. ^{[5
,6
]}

Reda, Wael A. ^{[5
,7
]}

Tawadros, Sameh R. ^{[5
,7
]}

Abdelkarim, Khaled ^{[5
,8
]}

El-Shehaby, Amr M. N. ^{[5
,7
]}

Emad, Reem M. ^{[5
,9
]}

Peker, Selcuk ^{[10
]}

Samanci, Yavuz ^{[10
]}

Lee, Cheng-chia ^{[11
,12
]}

Yang, Huai-che ^{[11
,12
]}

Delabar, Violaine ^{[13
]}

Mathieu, David ^{[13
]}

Tripathi, Manjul ^{[14
]}

Kearns, Kathryn Nicole ^{[15
]}

Bunevicius, Adomas ^{[15
]}

Sheehan, Jason P. ^{[15
]}

Chytka, Tomas ^{[16
]}

Liscak, Roman ^{[16
]}

Moreno, Nuria Martinez ^{[17
]}

Alvarez, Roberto Martinez ^{[17
]}

Grills, Inga S. ^{[18
]}

Parzen, Jacob S. ^{[18
]}

Cifarelli, Christopher P. ^{[19
]}

Rehman, Azeem A. ^{[19
]}

Speckter, Herwin ^{[20
,21
]}

Niranjan, Ajay ^{[1
]}

Lunsford, L. Dade ^{[1
]}

Abou-Al-Shaar, Hussam ^{[1
,2
]}

机构：

[1] Univ Pittsburgh, Med Ctr, Dept Neurol Surg, Pittsburgh, PA USA

[2] Univ Pittsburgh, Dept Neurol Surg, Med Ctr, 200 Lothrop St,Suite B-400, Pittsburgh, PA 15213 USA

[3] Univ Manitoba, Max Rady Coll Med, Dept Neurosurg, Winnipeg, MB, Canada

[4] Univ Miami, Sch Med, Dept Neurol Surg, Miami, FL USA

[5] Nasser Inst Hosp, Gamma Knife Ctr Cairo, Cairo, Egypt

[6] Benha Univ, Neurosurg Dept, Qalubya, Egypt

[7] Ain Shams Univ, Neurosurg Dept, Cairo, Egypt

[8] Ain Shams Univ, Clin Oncol Dept, Cairo, Egypt

[9] Cairo Univ, Natl Canc Inst, Radiat Oncol Dept, Cairo, Egypt

[10] Koc Univ, Sch Med, Dept Neurosurg, Istanbul, Turkiye

[11] Taipei Vet Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, Taiwan

[12] Natl Yang Ming Univ, Sch Med, Taipei, Taiwan

[13] Univ Sherbrooke, Ctr Rech CHUS, Dept Neurosurg, Sherbrooke, PQ, Canada

[14] Post Grad Inst Med Educ & Res, Dept Neurosurg, Chandigarh, India

[15] Univ Virginia, Dept Neurol Surg, Charlottesville, VA USA

[16] Homolce Hosp, Stereotact & Radiat Neurosurg, Prague, Czech Republic

[17] Hosp Ruber Int, Radiosurg Unit, Madrid, Spain

[18] Beaumont Hlth Syst, Dept Radiat Oncol, Royal Oak, MI USA

[19] West Virginia Univ, Dept Neurosurg, Morgantown, WV USA

[20] Ctr Gamma Knife Dominicano, Dept Radiol, Santo Domingo, Dominican Rep

[21] Cedimat, Radiol Dept, Santo Domingo, Dominican Rep

来源：

NEUROSURGERY | 2023年 / 92卷 / 05期

关键词：

Gamma Knife; Neurofibromatosis type 2; Malignant transformation; Stereotactic radiosurgery; Tumor control; Vestibular schwannoma; Case series; GAMMA-KNIFE RADIOSURGERY; ACOUSTIC NEUROMAS; HEARING PRESERVATION; TUMOR-CONTROL; MANAGEMENT;

D O I：

10.1227/neu.0000000000002436

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND: Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety.OBJECTIVE: To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS.METHODS: We performed a retrospective study of 267 patients with NF2 (328 VSs) who underwent single-session SRS at 12 centers participating in the International Radiosurgery Research Foundation. The median patient age was 31 years (IQR, 21-45 years), and 52% were male.RESULTS: A total of 328 tumors underwent SRS during a median follow-up time of 59 months (IQR, 23-112 months). At 10 and 15 years, the tumor control rates were 77% (95% CI: 69%-84%) and 52% (95% CI: 40%-64%), respectively, and the FFAT rate were 85% (95% CI: 79%-90%) and 75% (95% CI: 65%-86%), respectively. At 5 and 10 years, the serviceable hearing preservation rates were 64% (95% CI: 55%-75%) and 35% (95% CI: 25%-54%), respectively. In the multivariate analysis, age (hazards ratio: 1.03 [95% CI: 1.01-1.05]; P= .02) and bilateral VSs (hazards ratio: 4.56 [95% CI: 1.05-19.78]; P= .04) were predictors for serviceable hearing loss. Neither radiation-induced tumors nor malignant transformation were encountered in this cohort.CONCLUSION: Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.

引用

页码：934 / 944

页数：11

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