Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study.

Humans Neuroma, Acoustic / radiotherapy Retrospective Studies Radiosurgery / adverse effects Follow-Up Studies Hearing Treatment Outcome
Fractionation Hearing preservation Radiation dose Stereotactic radiosurgery Vestibular schwannoma

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 08 12 2022
revised: 23 05 2023
accepted: 24 05 2023
medline: 9 10 2023
pubmed: 3 6 2023
entrez: 2 6 2023
Statut: ppublish

Résumé

Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration. Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990-2020 and had pre- and post-treatment audiograms. Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12-60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS. Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.

Identifiants

DOI: 10.1016/j.wneu.2023.05.098 PMID: 37268187
pubmed: 37268187
pii: S1878-8750(23)00728-3
doi: 10.1016/j.wneu.2023.05.098
pii:
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e24-e33

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Steven D Chang (SD)

Department of Neurosurgery, Stanford University, Stanford, California, USA.

Alexander Muacevic (A)

European Cyberknife Center, Munich, Germany.

Andrea L Klein (AL)

The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: andreaklein@gwu.edu.

Jonathan H Sherman (JH)

Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.

Pantaleo Romanelli (P)

Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.

Peter L Santa Maria (PL)

Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California, USA.

Christoph Fuerweger (C)

European Cyberknife Center, Munich, Germany.

Isa Bossi Zanetti (I)

Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.

Giancarlo Beltramo (G)

Cyberknife Center, Centro Diagnostico Italiano, Milan, Italy.

Yona Vaisbush (Y)

Technion, Haifa, Israel.

Emma Tran (E)

Stanford University School of Medicine, Stanford, California, USA.

Austin Feng (A)

Stanford University School of Medicine, Stanford, California, USA.

Hao Teng (H)

Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Antonio Meola (A)

Department of Neurosurgery, Stanford University, Stanford, California, USA.

Iris Gibbs (I)

Department of Radiation Oncology, Stanford University, Stanford, California, USA.

Antony M Tolisano (AM)

Department of Otolaryngology, Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Joe Walter Kutz (JW)

Department of Otolaryngology and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Zabi Wardak (Z)

Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Lucien A Nedzi (LA)

Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Robert Hong (R)

Virginia Hospital Center, Arlington, Virginia, USA.

Don MacRae (D)

Virginia Hospital Center, Arlington, Virginia, USA.

Preet Sohal (P)

The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Elina Kapoor (E)

The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Parisa Sabet-Rasekh (P)

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Sam Maghami (S)

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Paola X Moncada (PX)

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Ashley Zaleski-King (A)

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Richard Amdur (R)

Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Ashkan Monfared (A)

Division of Otolaryngology - Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Neurosurgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Maladies du système nerveux › Atteintes des nerfs crâniens › Atteintes du nerf vestibulocochléaire › Neurinome de l'acoustique › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Techniques d'investigation › Techniques stéréotaxiques › Radiochirurgie › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système nerveux › Sensation › Ouïe › Impact of Cochlear Dose on Hearing...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Impact of Cochlear Dose on Hearing...