Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 16, Issue 6, Pages 742-747Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2008.09.023
Keywords
Radiosurgery; Vestibular schwannoma; Hearing preservation; Stereotactic radiosurgery; Gamma knife; Linac; Proton beam
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Radiosurgery has evolved into an effective alternative to microsurgical resection in the treatment of patients with vestibular schwannoma. We performed a systematic analysis of the literature in English on the radiosurgical treatment of vestibular schwannoma patients. A total of 254 published studies reported assessable and quantifiable outcome data of patients undergoing radiosurgery for vestibular schwannomas. American Association of Otolaryngology-Head and Neck Surgery (AAO-HNS) class A or B and Gardner-Robertson (GR) classification I or II were defined as having preserved hearing. A total of 5825 patients (74 articles) met our inclusion criteria. Practitioners who delivered an average dose of <= 12.5 Gy as the marginal dose reported having a higher hearing preservation rate (<= 12.5 Gy = 59% vs. >12.5 Gy = 53%, p = 0.0285). Age of the patient was not a significant prognostic factor for hearing preservation rates (<65 years = 58% vs. >65 years = 62%; p = 0.4317). The average overall follow-up was 41.2 months. Our data suggest that an overall hearing preservation rate of about 57% can be expected after radiosurgical treatment, and patients treated with <= 12.5 Gy were more likely to have preserved hearing. (C) 2009 Published by Elsevier Ltd.
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