1. Impact of pretreatment growth on Tumor control for vestibular schwannomas following gamma knife
- Author
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Philip V. Theodosopoulos, Penny K. Sneed, Annette M. Molinaro, Aaron D. Tward, Michael W. McDermott, Jonathan D. Breshears, and Joseph Chang
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Radiography ,Salvage treatment ,Urology ,Retrospective cohort study ,Gamma knife ,Tumor control ,Tertiary care ,Radiosurgery ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Vestibular Schwannomas ,medicine ,business ,030217 neurology & neurosurgery - 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 cm3 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.
- Published
- 2018