Journal article
Clinical and Imaging Outcomes After Trigeminal Schwannoma Radiosurgery: Results From a Multicenter, International Cohort Study
Neurosurgery, v 94(1), pp 165-173
01 Jan 2024
PMID: 37523519
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND AND OBJECTIVES: An international, multicenter, retrospective study was conducted to evaluate the long-term clinical outcomes and tumor control rates after stereotactic radiosurgery (SRS) for trigeminal schwannoma. METHODS: Patient data (N = 309) were collected from 14 international radiosurgery centers. The median patient age was 50 years (range 11-87 years). Sixty patients (19%) had prior resections. Abnormal facial sensation was the commonest complaint (49%). The anatomic locations were root (N = 40), ganglion (N = 141), or dumbbell type (N = 128). The median tumor volume was 4 cc (range, 0.2-30.1 cc), and median margin dose was 13 Gy (range, 10-20 Gy). Factors associated with tumor control, symptom improvement, and adverse radiation events were assessed. RESULTS: The median and mean time to last follow-up was 49 and 65 months (range 6-242 months). Greater than 5-year follow-up was available for 139 patients (45%), and 50 patients (16%) had longer than 10-year follow-up. The overall tumor control rate was 94.5%. Tumors regressed in 146 patients (47.2%), remained unchanged in 128 patients (41.4%), and stabilized after initial expansion in 20 patients (6.5%). Progression-free survival rates at 3 years, 5 years, and 10 years were 91%, 86%, and 80 %. Smaller tumor volume (less than 8 cc) was associated with significantly better progression-free survival (P = .02). Seventeen patients with sustained growth underwent further intervention at a median of 27 months (3-144 months). Symptom improvement was noted in 140 patients (45%) at a median of 7 months. In multivariate analysis primary, SRS (P = .003) and smaller tumor volume (P = .01) were associated with better symptom improvement. Adverse radiation events were documented in 29 patients (9%). CONCLUSION: SRS was associated with long-term freedom (10 year) from additional management in 80% of patients. SRS proved to be a valuable salvage option after resection. When used as a primary management for smaller volume tumors, both clinical improvement and prevention of new deficits were optimized.
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Details
- Title
- Clinical and Imaging Outcomes After Trigeminal Schwannoma Radiosurgery: Results From a Multicenter, International Cohort Study
- Creators
- Ajay Niranjan - Neurological SurgeryAndrew Faramand - Neurological SurgerySudesh S. Raju - University of Pittsburgh Medical CenterCheng-chia Lee - Taipei Veterans General HospitalHuai-che Yang - Taipei Veteran Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, TaiwanAhmed M. Nabeel - Benha UniversitySameh R. Tawadros - Ain Shams UniversityAmr M. N. El-Shehaby - Ain Shams UniversityKhaled Abdelkarim - Ain Shams UniversityReem M. Emad - Cairo UniversityWael A. Reda - Ain Shams UniversityRoberto Martinez Alvarez - Hospital Ruber InternacionalNuria E. Martinez Moreno - Hospital Ruber InternacionalRoman Liscak - Na Homolce HospitalJaromir May - Na Homolce HospitalDavid Mathieu - Université de SherbrookeAnne-Marie Langlois - Université de SherbrookeM. Harrison Snyder - University of Virginia Health SystemMatthew J. Shepard - Allegheny Health NetworkJason Sheehan - University of Virginia Health SystemBaha'eddin A. Muhsen - Cleveland Clin Fdn, Dept Neurol Surg, Cleveland, OH USAHamid Borghei-Razavi - Cleveland ClinicGene Barnett - Cleveland ClinicDouglas Kondziolka - NYU Langone HealthJohn G. Golfinos - NYU Langone HealthLuca Attuati - IRCCS Humanitas Research HospitalPiero Picozzi - IRCCS Humanitas Research HospitalJames McInerney - Penn State Milton S. Hershey Medical CenterLekhaj Chand Daggubati - Penn State Milton S. Hershey Medical CenterRonald E. Warnick - Jewish HospitalCaleb E. Feliciano - Gamma Knife Ctr Puerto Rico, Dept Neurosurg, San Juan, PR USAEric Carro - Gamma Knife Ctr Puerto Rico, Dept Neurosurg, San Juan, PR USADavid McCarthy - University of MiamiRobert M. Starke - University of MiamiHoward J. Landy - University of MiamiChristopher P. Cifarelli - West Virginia UniversityJohn A. Vargo - West Virginia UniversityJohn Flickinger - University of Pittsburgh Medical CenterL. Dade Lunsford - University of Pittsburgh Medical Center
- Publication Details
- Neurosurgery, v 94(1), pp 165-173
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001155444600005
- Scopus ID
- 2-s2.0-85179842283
- Other Identifier
- 991022154809404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery