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Title: Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study

Abstract

Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68) and -13.1 years (95% confidence intervals, -111.0 to -6.94), respectively. Tumor control, defined as a post-GKRS growth rate {<=}0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected bymore » treatment, but quality of life was improved.« less

Authors:
 [1];  [2];  [3];  [3];  [1];  [3];  [4];  [1];  [3]
  1. Institute of Surgical Sciences, University of Bergen, Bergen (Norway)
  2. Centre for Clinical Research, Haukeland University Hospital, Bergen (Norway)
  3. (Norway)
  4. Department of Neurosurgery, Haukeland University Hospital, Bergen (Norway)
Publication Date:
OSTI Identifier:
22149504
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CONTROL; NEOPLASMS; PATIENTS; RADIOTHERAPY; STANDARD OF LIVING; SURGERY; SYMPTOMS

Citation Formats

Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com, Wentzel-Larsen, Tore, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Pedersen, Paal-Henning, Department of Neurosurgery, Haukeland University Hospital, Bergen, Mahesparan, Ruby, Lund-Johansen, Morten, and Department of Neurosurgery, Haukeland University Hospital, Bergen. Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.03.047.
Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com, Wentzel-Larsen, Tore, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Pedersen, Paal-Henning, Department of Neurosurgery, Haukeland University Hospital, Bergen, Mahesparan, Ruby, Lund-Johansen, Morten, & Department of Neurosurgery, Haukeland University Hospital, Bergen. Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study. United States. doi:10.1016/J.IJROBP.2012.03.047.
Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com, Wentzel-Larsen, Tore, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Pedersen, Paal-Henning, Department of Neurosurgery, Haukeland University Hospital, Bergen, Mahesparan, Ruby, Lund-Johansen, Morten, and Department of Neurosurgery, Haukeland University Hospital, Bergen. Mon . "Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study". United States. doi:10.1016/J.IJROBP.2012.03.047.
@article{osti_22149504,
title = {Gamma Knife Treatment of Growing Vestibular Schwannoma in Norway: A Prospective Study},
author = {Varughese, Jobin Kotakkathu, E-mail: jobinv@gmail.com and Wentzel-Larsen, Tore and Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo and Norwegian Centre for Violence and Traumatic Stress Studies, Oslo and Pedersen, Paal-Henning and Department of Neurosurgery, Haukeland University Hospital, Bergen and Mahesparan, Ruby and Lund-Johansen, Morten and Department of Neurosurgery, Haukeland University Hospital, Bergen},
abstractNote = {Purpose: Gamma Knife radiosurgery (GKRS) has been increasingly used in the treatment of vestibular schwannoma (VS). Very few studies relate tumor control and post-treatment growth rates to pretreatment growth rates. Methods and Materials: We prospectively included 45 consecutive VS patients who were initially treated conservatively and then received GKRS between 2000 and 2007 because of demonstrated tumor growth. Pretreatment and post-treatment tumor volumes were estimated. Patients underwent audiograms, reported their symptoms, and responded to the Short Form General Health Survey (SF-36) questionnaire on each visit. Results: Volume doubling times before and after treatment were 1.36 years (95% confidence intervals, 1.14-1.68) and -13.1 years (95% confidence intervals, -111.0 to -6.94), respectively. Tumor control, defined as a post-GKRS growth rate {<=}0, was achieved in 71.1% of patients, with highest odds for tumor control among older patients and those with larger tumors. The 5-year retreatment-free survival rate was 93.9% (95% confidence intervals, 76.5-98.5). None of the clinical endpoints investigated showed statistically significant changes after GKRS, but improvement was seen in a few SF-36 parameters. Conclusions: GKRS alters the natural course of the tumor by reducing growth. Mathematic models yield poorer tumor control rates than those found by clinical assessment. Symptoms were unaffected by treatment, but quality of life was improved.},
doi = {10.1016/J.IJROBP.2012.03.047},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 84,
place = {United States},
year = {2012},
month = {10}
}