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Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery
OBJECTIVE: A lack of understanding of the clinical course of neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) often complicates the decision-making in terms of optimal timing and mode of treatment. We investigated the outcomes of stereotactic radiosurgery (SRS) in this population...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9523262/ https://www.ncbi.nlm.nih.gov/pubmed/36185258 http://dx.doi.org/10.3389/fonc.2022.996186 |
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author | Kim, Junhyung Byeon, Yukyeng Song, Sang Woo Cho, Young Hyun Hong, Chang-Ki Hong, Seok Ho Kim, Jeong Hoon Lee, Do Heui Park, Ji Eun Kim, Ho Sung Kim, Young-Hoon |
author_facet | Kim, Junhyung Byeon, Yukyeng Song, Sang Woo Cho, Young Hyun Hong, Chang-Ki Hong, Seok Ho Kim, Jeong Hoon Lee, Do Heui Park, Ji Eun Kim, Ho Sung Kim, Young-Hoon |
author_sort | Kim, Junhyung |
collection | PubMed |
description | OBJECTIVE: A lack of understanding of the clinical course of neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) often complicates the decision-making in terms of optimal timing and mode of treatment. We investigated the outcomes of stereotactic radiosurgery (SRS) in this population. METHODS: We retrospectively analyzed NF2 patients treated with Gamma-Knife SRS for VS in our tertiary referral center. A total of 41 treated lesions from 33 patients were collected with a follow-up period of 69.1 (45.0-104.8) months. We reviewed the treatment history, hearing function, and other treatment-related morbidities in individual cases. We also analyzed pre- and post-treatment tumor volumes via imaging studies. Longitudinal volumetric analyses were conducted for the tumor volume response of the 41 treated lesions following SRS. The growth pattern of 22 unirradiated lesions during an observation period of 83.4 (61.1-120.4) months was separately evaluated. RESULTS: Most treated lesions showed effective tumor control up to 85% at 60 months after SRS, whereas unirradiated lesions progressed with a relative volume increase of 14.0% (7.8-27.0) per year during the observation period. Twelve (29%) cases showed pseudoprogression with significant volume expansion in the early follow-up period, which practically reduced the rate of tumor control to 57% at 24 months. Among the patients with serviceable hearing, two (20%) cases lost the hearing function on the treated side during the early follow-up period within 24 months. CONCLUSIONS: Progressive NF2-associated VS can be adequately controlled by SRS but the short-term effects of this treatment are not highly advantageous in terms of preserving hearing function. SRS treatment candidates should therefore be carefully selected. |
format | Online Article Text |
id | pubmed-9523262 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95232622022-10-01 Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery Kim, Junhyung Byeon, Yukyeng Song, Sang Woo Cho, Young Hyun Hong, Chang-Ki Hong, Seok Ho Kim, Jeong Hoon Lee, Do Heui Park, Ji Eun Kim, Ho Sung Kim, Young-Hoon Front Oncol Oncology OBJECTIVE: A lack of understanding of the clinical course of neurofibromatosis type 2 (NF2)-associated vestibular schwannoma (VS) often complicates the decision-making in terms of optimal timing and mode of treatment. We investigated the outcomes of stereotactic radiosurgery (SRS) in this population. METHODS: We retrospectively analyzed NF2 patients treated with Gamma-Knife SRS for VS in our tertiary referral center. A total of 41 treated lesions from 33 patients were collected with a follow-up period of 69.1 (45.0-104.8) months. We reviewed the treatment history, hearing function, and other treatment-related morbidities in individual cases. We also analyzed pre- and post-treatment tumor volumes via imaging studies. Longitudinal volumetric analyses were conducted for the tumor volume response of the 41 treated lesions following SRS. The growth pattern of 22 unirradiated lesions during an observation period of 83.4 (61.1-120.4) months was separately evaluated. RESULTS: Most treated lesions showed effective tumor control up to 85% at 60 months after SRS, whereas unirradiated lesions progressed with a relative volume increase of 14.0% (7.8-27.0) per year during the observation period. Twelve (29%) cases showed pseudoprogression with significant volume expansion in the early follow-up period, which practically reduced the rate of tumor control to 57% at 24 months. Among the patients with serviceable hearing, two (20%) cases lost the hearing function on the treated side during the early follow-up period within 24 months. CONCLUSIONS: Progressive NF2-associated VS can be adequately controlled by SRS but the short-term effects of this treatment are not highly advantageous in terms of preserving hearing function. SRS treatment candidates should therefore be carefully selected. Frontiers Media S.A. 2022-09-16 /pmc/articles/PMC9523262/ /pubmed/36185258 http://dx.doi.org/10.3389/fonc.2022.996186 Text en Copyright © 2022 Kim, Byeon, Song, Cho, Hong, Hong, Kim, Lee, Park, Kim and Kim https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Kim, Junhyung Byeon, Yukyeng Song, Sang Woo Cho, Young Hyun Hong, Chang-Ki Hong, Seok Ho Kim, Jeong Hoon Lee, Do Heui Park, Ji Eun Kim, Ho Sung Kim, Young-Hoon Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title | Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title_full | Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title_fullStr | Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title_full_unstemmed | Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title_short | Vestibular schwannoma associated with neurofibromatosis type 2: Clinical course following stereotactic radiosurgery |
title_sort | vestibular schwannoma associated with neurofibromatosis type 2: clinical course following stereotactic radiosurgery |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9523262/ https://www.ncbi.nlm.nih.gov/pubmed/36185258 http://dx.doi.org/10.3389/fonc.2022.996186 |
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