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Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma

The efficacy of radiosurgery for neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) remains debatable. We retrospectively analyzed radiosurgical outcomes for NF2-associated VS compared to sporadic VS using our database of 422 consecutive VS patients. Twenty-five patients with 30 NF...

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Autores principales: Shinya, Yuki, Hasegawa, Hirotaka, Shin, Masahiro, Sugiyama, Takehiro, Kawashima, Mariko, Takahashi, Wataru, Iwasaki, Shinichi, Kashio, Akinori, Nakatomi, Hirofumi, Saito, Nobuhito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827030/
https://www.ncbi.nlm.nih.gov/pubmed/31591325
http://dx.doi.org/10.3390/cancers11101498
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author Shinya, Yuki
Hasegawa, Hirotaka
Shin, Masahiro
Sugiyama, Takehiro
Kawashima, Mariko
Takahashi, Wataru
Iwasaki, Shinichi
Kashio, Akinori
Nakatomi, Hirofumi
Saito, Nobuhito
author_facet Shinya, Yuki
Hasegawa, Hirotaka
Shin, Masahiro
Sugiyama, Takehiro
Kawashima, Mariko
Takahashi, Wataru
Iwasaki, Shinichi
Kashio, Akinori
Nakatomi, Hirofumi
Saito, Nobuhito
author_sort Shinya, Yuki
collection PubMed
description The efficacy of radiosurgery for neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) remains debatable. We retrospectively analyzed radiosurgical outcomes for NF2-associated VS compared to sporadic VS using our database of 422 consecutive VS patients. Twenty-five patients with 30 NF2-associated VSs with a mean follow-up of 121 months were identified. NF2-associated VSs exhibited excellent tumor control (10-year cumulative rate, 92% vs. 92% in sporadic VSs; p = 0.945) and worse overall survival (73% vs. 97%; p = 0.005), mainly due to tumor progression other than the treated VSs. The presence of NF2 was not associated with failed tumor control via multivariate Cox proportional hazard analyses. No difference in radiation-induced adverse events (RAEs) was confirmed between cohorts, and prescription dose (hazard ratio 8.30, 95% confidence interval 3.19–21.62, p < 0.001) was confirmed as a risk for cranial nerve injuries via multivariate analysis. Further analysis after propensity score matching using age, volume, and sex as covariates showed that NF2-associated VSs exhibited excellent local control (100% vs. 93%; p = 0.240) and worse overall survival (67% vs. 100%; p = 0.002) with no significant difference in RAEs. Excellent long-term tumor control and minimal invasiveness may make radiosurgery a favorable therapeutic option for NF2 patients with small to medium VS, preferably with non-functional hearing or deafness in combination with postoperative tumor growth or progressive non-operated tumors, or with functional hearing by patients’ wish.
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spelling pubmed-68270302019-11-18 Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma Shinya, Yuki Hasegawa, Hirotaka Shin, Masahiro Sugiyama, Takehiro Kawashima, Mariko Takahashi, Wataru Iwasaki, Shinichi Kashio, Akinori Nakatomi, Hirofumi Saito, Nobuhito Cancers (Basel) Article The efficacy of radiosurgery for neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) remains debatable. We retrospectively analyzed radiosurgical outcomes for NF2-associated VS compared to sporadic VS using our database of 422 consecutive VS patients. Twenty-five patients with 30 NF2-associated VSs with a mean follow-up of 121 months were identified. NF2-associated VSs exhibited excellent tumor control (10-year cumulative rate, 92% vs. 92% in sporadic VSs; p = 0.945) and worse overall survival (73% vs. 97%; p = 0.005), mainly due to tumor progression other than the treated VSs. The presence of NF2 was not associated with failed tumor control via multivariate Cox proportional hazard analyses. No difference in radiation-induced adverse events (RAEs) was confirmed between cohorts, and prescription dose (hazard ratio 8.30, 95% confidence interval 3.19–21.62, p < 0.001) was confirmed as a risk for cranial nerve injuries via multivariate analysis. Further analysis after propensity score matching using age, volume, and sex as covariates showed that NF2-associated VSs exhibited excellent local control (100% vs. 93%; p = 0.240) and worse overall survival (67% vs. 100%; p = 0.002) with no significant difference in RAEs. Excellent long-term tumor control and minimal invasiveness may make radiosurgery a favorable therapeutic option for NF2 patients with small to medium VS, preferably with non-functional hearing or deafness in combination with postoperative tumor growth or progressive non-operated tumors, or with functional hearing by patients’ wish. MDPI 2019-10-07 /pmc/articles/PMC6827030/ /pubmed/31591325 http://dx.doi.org/10.3390/cancers11101498 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shinya, Yuki
Hasegawa, Hirotaka
Shin, Masahiro
Sugiyama, Takehiro
Kawashima, Mariko
Takahashi, Wataru
Iwasaki, Shinichi
Kashio, Akinori
Nakatomi, Hirofumi
Saito, Nobuhito
Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title_full Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title_fullStr Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title_full_unstemmed Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title_short Long-Term Outcomes of Stereotactic Radiosurgery for Vestibular Schwannoma Associated with Neurofibromatosis Type 2 in Comparison to Sporadic Schwannoma
title_sort long-term outcomes of stereotactic radiosurgery for vestibular schwannoma associated with neurofibromatosis type 2 in comparison to sporadic schwannoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827030/
https://www.ncbi.nlm.nih.gov/pubmed/31591325
http://dx.doi.org/10.3390/cancers11101498
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