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A systematic review and meta-analysis of stereotactic radiosurgery as a primary treatment in fast-growing vestibular schwannomas

Published online by Cambridge University Press:  17 May 2023

Faizan Shah ,
Leanne O W Hamilton ,
Constantina P Yiannakis ,
Mohd Afiq Mohd Slim Open the ORCID record for Mohd Afiq Mohd Slim [Opens in a new window]  and
Georgios Kontorinis
Faizan Shah
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Leanne O W Hamilton
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Constantina P Yiannakis
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Mohd Afiq Mohd Slim*
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Georgios Kontorinis
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Corresponding author: Mohd Afiq Mohd Slim; Email: chain1993@yahoo.com
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Abstract

Background

Stereotactic radiosurgery has been shown to be an effective method of managing vestibular schwannomas. The primary aim here is to establish the impact of pre-treatment fast-growing vestibular schwannomas on the efficacy of stereotactic radiosurgery.

Methods

PubMed, Medline and Embase databases were used. The ROBINS-I (‘Risk Of Bias In Non-randomised Studies - of Interventions’) tool was utilised to assess for risk of bias. Proportionate meta-analysis and sub-analysis for fast-growing tumours were performed to explore the success rate of stereotactic radiosurgery in stabilising or decreasing the tumour burden in vestibular schwannomas.

Results

Four moderate risk studies were included in the analysis. Overall, 91 per cent (95 per cent confidence interval = 0.83–0.97, p < 0.01, I2 = 80 per cent) of the tumours demonstrated successful size reduction or stabilisation following stereotactic radiosurgery. Nevertheless, the efficacy of stereotactic radiosurgery in reducing or stabilising fast-growing vestibular schwannomas decreased by 79 per cent (95 per cent confidence interval = 0.64–0.91, p = 0.11, I2 = 62 per cent).

Conclusion

Stereotactic radiosurgery has a statistically significant success rate in stabilising or decreasing the vestibular schwannoma size. This success rate is diminished in fast-growing vestibular schwannomas.

Keywords

Vestibular schwannomaacoustic neuromastereotactic radiosurgery
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1193 - 1199
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mohd Afiq Mohd Slim takes responsibility for the integrity of the content of the paper

Presented at the North American Skull Base Society 31st Annual Meeting, 16–17 February 2022, Phoenix, Arizona, USA.

References

Foote, KD, Friedman, WA, Buatti, JM, Meeks, SL, Bova, FJ, Kubilis, PS. Analysis of risk factors associated with radiosurgery for vestibular schwannoma. J Neurosurg 2001;95:440–9CrossRefGoogle ScholarPubMed
Linskey, ME, Flickinger, JC, Lunsford, LD. Cranial nerve length predicts the risk of delayed facial and trigeminal neuropathies after acoustic tumor stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1993;25:227–33CrossRefGoogle ScholarPubMed
Stangerup, S-E, Caye-Thomasen, P, Tos, M, Thomsen, J. The natural history of vestibular schwannoma. Otol Neurotol 2006;27:547–52CrossRefGoogle ScholarPubMed
Carlson, ML, Tveiten, OV, Driscoll, CL, Goplen, FK, Neff, BA, Pollock, BE et al. Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls. J Neurosurg 2015;122:833–42CrossRefGoogle ScholarPubMed
Gauden, A, Weir, P, Hawthorne, G, Kaye, A. Systematic review of quality of life in the management of vestibular schwannoma. J Clin Neurosci 2011;18:1573–84CrossRefGoogle ScholarPubMed
Chopra, R, Kondziolka, D, Niranjan, A, Lunsford, LD, Flickinger, JC. Long-term follow-up of acoustic schwannoma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys 2007;68:845–51CrossRefGoogle ScholarPubMed
Flickinger, JC, Kondziolka, D, Niranjan, A, Maitz, A, Voynov, G, Lunsford, LD. Acoustic neuroma radiosurgery with marginal tumor doses of 12 to 13 Gy. Int J Radiat Oncol Biol Phys 2004;60:225–30CrossRefGoogle ScholarPubMed
Nakaya, K, Niranjan, A, Kondziolka, D, Kano, H, Khan, AA, Nettel, B et al. Gamma knife radiosurgery for benign tumors with symptoms from brainstem compression. Int J Radiat Oncol Biol Phys 2010;77:988–95CrossRefGoogle ScholarPubMed
Wangerid, T, Bartek, J, Svensson, M, Förander, P. Long-term quality of life and tumour control following gamma knife radiosurgery for vestibular schwannoma. Acta Neurochir (Wien) 2013;156:389–96CrossRefGoogle ScholarPubMed
Hayhurst, C, Monsalves, E, Bernstein, M, Gentili, F, Heydarian, M, Tsao, M et al. Predicting nonauditory adverse radiation effects following radiosurgery for vestibular schwannoma: a volume and dosimetric analysis. Int J Radiat Oncol Biol Phys 2012;82:2041–6CrossRefGoogle ScholarPubMed
Hayhurst, C, Zadeh, G. Tumor pseudoprogression following radiosurgery for vestibular schwannoma. Neuro Oncol 2012;14:87–92CrossRefGoogle ScholarPubMed
Rockne, R, Rockhill, JK, Mrugala, M, Spence, AM, Kalet, I, Hendrickson, K et al. Predicting the efficacy of radiotherapy in individual glioblastoma patients in vivo: a mathematical modeling approach. Phys Med Biol 2010;55:3271–85CrossRefGoogle ScholarPubMed
Lau, T, Olivera, R, Miller, T, Downes, K, Danner, C, van Loveren, HR et al. Paradoxical trends in the management of vestibular schwannoma in the United States: clinical article. J Neurosurg 2012;117:514–19CrossRefGoogle Scholar
Miller, T, Lau, T, Vasan, R, Danner, C, Samy Youssef, A, van Loveren, H et al. Reporting success rates in the treatment of vestibular schwannomas: are we accounting for the natural history? J Clin Neurosci 2014;21:914–18CrossRefGoogle ScholarPubMed
Sweeney, P, Yajnik, S, Hartsell, W, Bovis, G, Venkatesan, J. Stereotactic radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am 2009;42:655–63CrossRefGoogle ScholarPubMed
Marston, AP, Jacob, JT, Carlson, ML, Pollock, BE, Driscoll, CLW, Link, MJ. Pretreatment growth rate as a predictor of tumor control following gamma knife radiosurgery for sporadic vestibular schwannoma. J Neurosurg 2017;127:380–7CrossRefGoogle ScholarPubMed
Niu, NN, Niemierko, A, Larvie, M, Curtin, H, Loeffler, JS, McKenna, MJ et al. Pretreatment growth rate predicts radiation response in vestibular schwannomas. Int J Radiat Oncol Biol Phys 2014;89:113–19CrossRefGoogle ScholarPubMed
Timmer, FCA, Mulder, JJS, Hanssens, PEJ, van Overbeeke, JJ, Donders, RT, Cremers, CWRJ et al. Gamma knife radiosurgery for vestibular schwannomas: identification of predictors for continued tumor growth and the influence of documented tumor growth preceding radiation treatment. Laryngoscope 2011;121:1834–8CrossRefGoogle ScholarPubMed
Varughese, JK, Wentzel-Larsen, T, Pedersen, PH, Mahesparan, R, Lund-Johansen, M. Gamma knife treatment of growing vestibular schwannoma in Norway: a prospective study. Int J Radiat Oncol Biol Phys 2012;84:e161–6CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, Altman, D, Antes, G et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097CrossRefGoogle ScholarPubMed
Sterne, JA, Hernán, MA, Reeves, BC, Savović, J, Berkman, ND, Viswanathan, M et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016;355:i4919CrossRefGoogle ScholarPubMed
Harrer, M, Cuijpers, P, Furukawa, TA, Ebert, D. Doing Meta-Analysis with R: A Hands-On Guide. Boca Raton, FL: CRC Press, 2022Google Scholar
Larjani, S, Monsalves, E, Pebdani, H, Krischek, B, Gentili, F, Cusimano, M et al. Identifying predictors of early growth response and adverse radiation effects of vestibular schwannomas to radiosurgery. PLoS One 2014;9:e110823CrossRefGoogle ScholarPubMed
Langenhuizen, PPJH, Zinger, S, Hanssens, PEJ, Kunst, HPM, Mulder, JJS, Leenstra, S et al. Influence of pretreatment growth rate on gamma knife treatment response for vestibular schwannoma: a volumetric analysis. J Neurosurg 2018;131:1405–12CrossRefGoogle Scholar
Balduzzi, S, Rücker, G, Schwarzer, G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health 2019;22:153–60CrossRefGoogle Scholar
Murad, MH, Sultan, S, Haffar, S, Bazerbachi, F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med 2018;23:60–3CrossRefGoogle ScholarPubMed
Ton, T, Sheldon, A, Tikka, T, Locke, R, Crowther, JA, Kontorinis, G. Imaging post stereotactic radiosurgery for vestibular schwannomas: when should we scan? Otol Neurotol 2021;42:e216–21CrossRefGoogle ScholarPubMed
Killeen, DE, Tolisano, AM, Isaacson, B, Kutz, JW, Barnett, S, Wardak, Z et al. Vestibular schwannoma tumor size and growth rate predict response with gamma knife stereotactic radiosurgery. J Neurol Surg B Skull Base 2020;83:11–18Google ScholarPubMed
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