Impact of pretreatment growth on Tumor control for vestibular schwannomas following gamma knife. (8th November 2018)

• Record Type: Journal Article
• Authors: Chang, Joseph; Breshears, Jonathan D.; Molinaro, Annette M.; Sneed, Penny K.; McDermott, Michael W.; Theodosopoulos, Philip V.; Tward, Aaron D.
• Is Part Of: Laryngoscope. Volume 129:Number 3(2019)
• Page Start: 743
• Page End: 747
• Publication Date: 2018-11-08
• Subjects: Gamma knife -- radiosurgery -- vestibular schwannoma -- volumetric tumor analysis; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.27427
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objectives/Hypothesis: To determine if volumetric growth prior to gamma knife (GK) radiosurgery predicts long‐term tumor control. Study Design: Retrospective cohort study. Methods: Sporadic vestibular schwannomas (VS) treated with GK between 2002 and 2014 at a single tertiary care center were identified. Patients were included if they had over 6 months of pretreatment observation and over 1.5 years of posttreatment follow‐up. Volumetric tumor analysis was performed on T1 postcontrast imaging. Pretreatment and posttreatment volume change was calculated. Tumors with over 20% volume increase were classified as growing. Results: There were 62 patients included in this study; 48 had pretreatment growth and 14 had no pretreatment growth. Median tumor volume was 0.58 ± 1.8 cm 3 and median follow‐up was 3.3 ± 2.0 years. For tumors with and without pretreatment growth, salvage treatment rates were 2% and 7% ( P = .35), and posttreatment radiologic stability rates were 73% and 86%, respectively ( P = .33). Median pretreatment growth was 27 ± 33% per year for tumors with posttreatment radiographic growth and 18 ± 26% per year for tumors without posttreatment radiographic growth ( P = .99). Conclusions: Pretreatment growth was not associated with increased salvage treatment or posttreatment radiographic progression rates in VS following GK. Level of Evidence: 4 Laryngoscope, 129:743–747, 2019