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Clinical and Imaging Outcomes After Trigeminal Schwannoma Radiosurgery: Results From a Multicenter, International Cohort Study

A. Niranjan, A. Faramand, SS. Raju, CC. Lee, HC. Yang, AM. Nabeel, SR. Tawadros, AMN. El-Shehaby, K. Abdelkarim, RM. Emad, WA. Reda, RM. Álvarez, NEM. Moreno, R. Liscak, J. May, D. Mathieu, AM. Langlois, MH. Snyder, MJ. Shepard, J. Sheehan, BA....

. 2024 ; 94 (1) : 165-173. [pub] 20230731

Jazyk angličtina Země Spojené státy americké

Typ dokumentu multicentrická studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24000162

BACKGROUND AND OBJECTIVES: An international, multicenter, retrospective study was conducted to evaluate the long-term clinical outcomes and tumor control rates after stereotactic radiosurgery (SRS) for trigeminal schwannoma. METHODS: Patient data (N = 309) were collected from 14 international radiosurgery centers. The median patient age was 50 years (range 11-87 years). Sixty patients (19%) had prior resections. Abnormal facial sensation was the commonest complaint (49%). The anatomic locations were root (N = 40), ganglion (N = 141), or dumbbell type (N = 128). The median tumor volume was 4 cc (range, 0.2-30.1 cc), and median margin dose was 13 Gy (range, 10-20 Gy). Factors associated with tumor control, symptom improvement, and adverse radiation events were assessed. RESULTS: The median and mean time to last follow-up was 49 and 65 months (range 6-242 months). Greater than 5-year follow-up was available for 139 patients (45%), and 50 patients (16%) had longer than 10-year follow-up. The overall tumor control rate was 94.5%. Tumors regressed in 146 patients (47.2%), remained unchanged in 128 patients (41.4%), and stabilized after initial expansion in 20 patients (6.5%). Progression-free survival rates at 3 years, 5 years, and 10 years were 91%, 86%, and 80 %. Smaller tumor volume (less than 8 cc) was associated with significantly better progression-free survival ( P = .02). Seventeen patients with sustained growth underwent further intervention at a median of 27 months (3-144 months). Symptom improvement was noted in 140 patients (45%) at a median of 7 months. In multivariate analysis primary, SRS ( P = .003) and smaller tumor volume ( P = .01) were associated with better symptom improvement. Adverse radiation events were documented in 29 patients (9%). CONCLUSION: SRS was associated with long-term freedom (10 year) from additional management in 80% of patients. SRS proved to be a valuable salvage option after resection. When used as a primary management for smaller volume tumors, both clinical improvement and prevention of new deficits were optimized.

Clinical Oncology Department Faculty of Medicine Ain Shams University Cairo Egypt

Department of Neurologic Surgery Cleveland Clinic Foundation Cleveland Ohio USA

Department of Neurologic Surgery University of Miami Coral Gables Florida USA

Department of Neurologic Surgery University of Virginia Health System Charlottesville Virginia USA

Department of Neurologic Surgery West Virginia University Morgantown West Virginia USA

Department of Neurological Surgery University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA

Department of Neurosurgery Allegheny Health Network Pittsburgh Pennsylvania USA

Department of Neurosurgery Gamma Knife Center Jewish Hospital Mayfield Clinic Cincinnati Ohio USA

Department of Neurosurgery Gamma Knife Center of Puerto Rico San Juan Puerto Rico

Department of Neurosurgery Gamma Knife Humanitas Research Hospital Milan Italy

Department of Neurosurgery Neurological Institute Taipei Veteran General Hospital Taipei Taiwan

Department of Neurosurgery Penn State Hershey Medical Center Hershey Pennsylvania USA

Department of Neurosurgery Université de Sherbrooke Centre de recherche du CHUS Sherbrooke Québec Canada

Department of Stereotactic and Radiation Neurosurgery Na Homolce Hospital Prague Czech Republic

Departments of Neurosurgery and Medical Physics NYU Langone Health System New York New York USA

Gamma Knife Center Cairo Cairo Egypt

Neurosurgery Department Faculty of Medicine Ain Shams University Cairo Egypt

Neurosurgery Department Faculty of Medicine Benha University Qalubya Egypt

Radiation Oncology Department National Cancer Institute Cairo University Cairo Egypt

RS Unit Ruber International Hospital Madrid Spain

Citace poskytuje Crossref.org

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