Impact of the Mean Cochlear Biologically Effective Dose on Hearing Preservation After Stereotactic Radiosurgery for Vestibular Schwannoma: A Retrospective Longitudinal Analysis.
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
11 Jul 2023
11 Jul 2023
Historique:
received:
25
03
2023
accepted:
19
05
2023
pmc-release:
11
07
2024
medline:
11
7
2023
pubmed:
11
7
2023
entrez:
11
7
2023
Statut:
aheadofprint
Résumé
Stereotactic radiosurgery (SRS) is a useful alternative for small- to medium-sized vestibular schwannoma. To evaluate whether biologically effective dose (BEDGy2.47), calculated for mean (BEDGy2.47 mean) and maximal (BEDGy2.47 max) cochlear dose, is relevant for hearing preservation. This is a retrospective longitudinal single-center study. Were analyzed 213 patients with useful baseline hearing. Risk of hearing decline was assessed for Gardner-Robertson classes and pure tone average (PTA) loss. The mean follow-up period was 39 months (median 36, 6-84). Hearing decline (Gardner-Robertson class) 3 years after SRS was associated with higher cochlear BEDGy2.47 mean (odds ratio [OR] 1.39, P = .009). Moreover, BEDGy2.47 mean was more relevant as compared with BEDGy2.47 max (OR 1.13, P = .04). Risk of PTA loss (continuous outcome, follow-up minus baseline) was significantly corelated with BEDGy2.47 mean at 24 (beta coefficient 1.55, P = .002) and 36 (beta coefficient 2.01, P = .004) months after SRS. Risk of PTA loss (>20 dB vs ≤) was associated with higher BEDGy2.47 mean at 6 (OR 1.36, P = .002), 12 (OR 1.36, P = .007), and 36 (OR 1.37, P = .02) months. Risk of hearing decline at 36 months for the BEDGy2.47 mean of 7-8, 10, and 12 Gy2.47 was 28%, 57%, and 85%, respectively. Cochlear BEDGy2.47 mean is relevant for hearing decline after SRS and more relevant as compared with BEDGy2.47 max. Three years after SRS, this was sustained for all hearing decline evaluation modalities. Our data suggest the BEDGy2.47 mean cut-off of ≤8 Gy2.47 for better hearing preservation rates.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Stereotactic radiosurgery (SRS) is a useful alternative for small- to medium-sized vestibular schwannoma. To evaluate whether biologically effective dose (BEDGy2.47), calculated for mean (BEDGy2.47 mean) and maximal (BEDGy2.47 max) cochlear dose, is relevant for hearing preservation.
METHODS
METHODS
This is a retrospective longitudinal single-center study. Were analyzed 213 patients with useful baseline hearing. Risk of hearing decline was assessed for Gardner-Robertson classes and pure tone average (PTA) loss. The mean follow-up period was 39 months (median 36, 6-84).
RESULTS
RESULTS
Hearing decline (Gardner-Robertson class) 3 years after SRS was associated with higher cochlear BEDGy2.47 mean (odds ratio [OR] 1.39, P = .009). Moreover, BEDGy2.47 mean was more relevant as compared with BEDGy2.47 max (OR 1.13, P = .04). Risk of PTA loss (continuous outcome, follow-up minus baseline) was significantly corelated with BEDGy2.47 mean at 24 (beta coefficient 1.55, P = .002) and 36 (beta coefficient 2.01, P = .004) months after SRS. Risk of PTA loss (>20 dB vs ≤) was associated with higher BEDGy2.47 mean at 6 (OR 1.36, P = .002), 12 (OR 1.36, P = .007), and 36 (OR 1.37, P = .02) months. Risk of hearing decline at 36 months for the BEDGy2.47 mean of 7-8, 10, and 12 Gy2.47 was 28%, 57%, and 85%, respectively.
CONCLUSION
CONCLUSIONS
Cochlear BEDGy2.47 mean is relevant for hearing decline after SRS and more relevant as compared with BEDGy2.47 max. Three years after SRS, this was sustained for all hearing decline evaluation modalities. Our data suggest the BEDGy2.47 mean cut-off of ≤8 Gy2.47 for better hearing preservation rates.
Identifiants
pubmed: 37431994
doi: 10.1227/neu.0000000000002609
pii: 00006123-990000000-00806
pmc: PMC10695539
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.
Références
Acta Otorhinolaryngol Belg. 2003;57(3):197-204
pubmed: 14571654
Neurosurgery. 2022 Jan 1;90(1):140-147
pubmed: 34982881
World Neurosurg. 2020 Feb;134:e204-e213
pubmed: 31606504
J Neurosurg. 2011 Nov;115(5):885-93
pubmed: 21838503
J Spinal Disord. 1996 Jun;9(3):251-6
pubmed: 8854282
J Neurosurg. 2010 Dec;113 Suppl:112-21
pubmed: 21121793
Acta Neurochir (Wien). 2007;149(7):647-60; discussion 660
pubmed: 17558460
Neurosurg Focus. 2018 Mar;44(3):E4
pubmed: 29490553
Neurosurgery. 2022 Oct 1;91(4):648-657
pubmed: 35973088
J Neurosurg. 2009 Oct;111(4):863-73
pubmed: 19284227
J Neurol Neurosurg Psychiatry. 2009 Feb;80(2):218-27
pubmed: 18977821
Br J Radiol. 1989 Aug;62(740):679-94
pubmed: 2670032
Stereotact Funct Neurosurg. 2011;89(1):25-33
pubmed: 21160240
J Neurosurg. 2000 Dec;93 Suppl 3:82-9
pubmed: 11143269
Neurosurgery. 2020 Sep 1;87(3):538-546
pubmed: 32267504
Prog Neurol Surg. 2012;25:39-54
pubmed: 22236667
J Neurol Surg B Skull Base. 2018 Aug;79(4):335-342
pubmed: 30009113
Adv Radiat Oncol. 2022 Aug 28;7(6):101059
pubmed: 36420205
Clin Endocrinol (Oxf). 2021 Mar;94(3):424-433
pubmed: 32984972
N Engl J Med. 2021 Apr 8;384(14):1335-1348
pubmed: 33826821
Otol Neurotol. 2001 Jan;22(1):87-94
pubmed: 11314723
Neurosurgery. 2012 Feb;70(2):334-40; discussion 340-1
pubmed: 21826031
Otolaryngol Head Neck Surg. 1985 Apr;93(2):146-7
pubmed: 3921901
Cancer. 2005 Aug 1;104(3):580-90
pubmed: 15952200
N Engl J Med. 1998 Nov 12;339(20):1426-33
pubmed: 9811917
Neurosurgery. 2009 Feb;64(2):289-96; discussion 296
pubmed: 19057423
Int J Radiat Oncol Biol Phys. 1982 Nov;8(11):1981-97
pubmed: 6759484
Biomed Res Int. 2021 Dec 21;2021:3548706
pubmed: 34970625
Neurosurgery. 2006 Jul;59(1):77-85; discussion 77-85
pubmed: 16823303
J Neurosurg. 2008 Dec;109 Suppl:129-36
pubmed: 19123899
J Neurosurg. 2020 Jul 24;134(6):1901-1911
pubmed: 32707557
Semin Radiat Oncol. 2008 Oct;18(4):234-9
pubmed: 18725109
J Neurosurg. 2002 Nov;97(5):1091-100
pubmed: 12450031
Neurosurgery. 2019 Dec 1;85(6):E1084-E1094
pubmed: 31270543
Br J Radiol. 2010 Jul;83(991):554-68
pubmed: 20603408
Otol Neurotol. 2006 Feb;27(2):234-41
pubmed: 16436995
Otol Neurotol. 2018 Jun;39(5):628-631
pubmed: 29561382
Acta Neurochir (Wien). 2017 Jul;159(7):1197-1211
pubmed: 28516364
Neurosurgery. 2023 Jun 1;92(6):1216-1226
pubmed: 36727756
J Neurosurg. 2016 Dec;125(Suppl 1):73-82
pubmed: 27903185
Neurosurgery. 2011 Sep;69(3):605-13; discussion 613-4
pubmed: 21471832
World Neurosurg. 2017 Sep;105:737-744
pubmed: 28647663
Mayo Clin Proc. 2021 May;96(5):1157-1164
pubmed: 33958052
Ann Otol Rhinol Laryngol. 1988 Jan-Feb;97(1):55-66
pubmed: 3277525
World Neurosurg. 2021 Aug;152:e512-e522
pubmed: 34098139
J Neurosurg. 2007 Oct;107(4):733-9
pubmed: 17937216
J Neurosurg. 2010 Dec;113 Suppl:105-11
pubmed: 21121792
Neurosurgery. 2010 Nov;67(5):1335-40; discussion 1340
pubmed: 20871439
Neurosurgery. 2010 Sep;67(3):640-4; discussion 644-5
pubmed: 20647969
J Radiosurg SBRT. 2017;5(1):5-24
pubmed: 29296459
J Neurosurg. 2013 Mar;118(3):571-8
pubmed: 23216466
Neurosurg Focus. 2012 Sep;33(3):E8
pubmed: 22937859
Neurosurgery. 2014 May;74(5):466-74; discussion 474
pubmed: 24476904