Journal article
Vestibular Schwannoma International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS Study
International journal of radiation oncology, biology, physics, v 120(2), pp 454-464
01 Oct 2024
PMID: 38588868
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: The present study assesses the safety and efficacy fi cacy of stereotactic radiosurgery (SRS) versus observation for Koos grade 1 and 2 vestibular schwannoma (VS), benign tumors affecting hearing and neurological function. Methods and Materials: This multicenter study analyzed data from Koos grade 1 and 2 VS patients managed with SRS (SRS group) or observation (observation group). Propensity score matching balanced patient demographics, tumor volume, and audiometry. Outcomes measured were tumor control, serviceable hearing preservation, and neurological outcomes. Results: In 125 matched patients in each group with a 36-month median follow-up (P = .49), SRS yielded superior 5- and 10- year tumor control rates (99% CI, 97.1%-100%, and 91.9% CI, 79.4%-100%) versus observation (45.8% CI, 36.8%-57.2%, and 22% CI, 13.2%-36.7%; P < .001). Serviceable hearing preservation rates at 5 and 9 years were comparable (SRS 60.4% CI, 49.9%-73%, vs observation 51.4% CI, 41.3%-63.9%, and SRS 27% CI, 14.5%-50.5%, vs observation 30% CI, 17.2%-52.2%; P = .53). SRS were associated with lower odds of tinnitus (OR = 0.39, P = .01), vestibular dysfunction (OR = 0.11, P = .004), and any cranial nerve palsy (OR = 0.36, P = .003), with no change in cranial nerves 5 or 7 (P> > .05). Composite endpoints of study tumor progression and/or any of the previous outcomes showed significant fi cant lower odds associated with SRS compared with observation alone (P < .001). Conclusions: SRS management in matched cohorts of Koos grade 1 and 2 VS patients demonstrated superior tumor control, comparable hearing preservation rates, and significantly fi cantly lower odds of experiencing neurological deficits. fi cits. These fi ndings delineate the safety and efficacy fi cacy of SRS in the management of this patient population. (c) 2024 Elsevier Inc. All rights reserved.
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Details
- Title
- Vestibular Schwannoma International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS Study
- Creators
- Othman Bin-Alamer - University of Pittsburgh Medical CenterHussam Abou-Al-Shaar - University of Pittsburgh Medical CenterSelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityIsabelle Pelcher - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellSabrina Begley - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellAnuj Goenka - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellMichael Schulder - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellJean-Nicolas Tourigny - Université de SherbrookeDavid Mathieu - Université de SherbrookeAndrenne Hamel - Univ Sherbrooke, Ctr Rech CHUS, Dept Neurosurg, Sherbrooke, PQ, CanadaRobert G. Briggs - University of Southern CaliforniaCheng Yu - University of Southern CaliforniaGabriel Zada - University of Southern CaliforniaSteven L. Giannotta - University of Southern CaliforniaHerwin Spekter - Birmingham Repertory TheatreSarai Palque - Instituto Tecnológico de Santo DomingoManjul Tripathi - Post Graduate Institute of Medical Education and ResearchSaurabh Kumar - Post Graduate Institute of Medical Education and ResearchRupinder Kaur - Post Graduate Institute of Medical Education and ResearchNarendra Kumar - Post Graduate Institute of Medical Education and ResearchBrandon Rogowski - Drexel UniversityMatthew J. Shepard - Allegheny Health NetworkBryan A. Johnson - WinnMedDaniel M. Trifiletti - WinnMedRonald E. Warnick - Jewish HospitalSamantha Dayawansa - University of VirginiaElad Mashiach - NYU Langone HealthFernando De Nigris Vasconcellos - NYU Langone, Dept Neurosurg, New York, NY USAKenneth Bernstein - NYU Langone HealthZane Schnurman - NYU Langone HealthJuan Alzate - Manhattan Institute for Policy ResearchDouglas Kondziolka - NYU Langone HealthJason P. Sheehan - University of Virginia
- Publication Details
- International journal of radiation oncology, biology, physics, v 120(2), pp 454-464
- Publisher
- Elsevier
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001312853800001
- Scopus ID
- 2-s2.0-85192169529
- Other Identifier
- 991022154810904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging