Robinett Zachary N, Walz Patrick C, Miles-Markley Beth, Moberly Aaron C, Welling D Bradley
Department of Otolaryngology Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA.
Department of Otolaryngology Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Otolaryngol Head Neck Surg. 2014 Jun;150(6):1024-32. doi: 10.1177/0194599814524531. Epub 2014 Mar 4.
To compare long-term quality-of-life outcomes in vestibular schwannoma patients managed with observation, microsurgery, or stereotactic radiation.
ross-sectional survey with retrospective chart review.
Tertiary care center.
The Penn Acoustic Neuroma Quality of Life (PANQOL) survey was mailed to 600 patients treated for vestibular schwannoma. Patients were separated by treatment and subsequently subdivided by years of follow-up (0-5, 6-10, and >10 years). Composite quality-of-life (cQOL) scores and subscores for hearing, balance, facial nerve, pain, anxiety, energy, and general health were calculated. Scores were compared among treatment groups as a whole, among treatment groups at each time interval, and within treatment groups over time using a 2-tailed analysis of variance and paired t test.
The survey return rate was 49%, and the mean follow-up was 7.9 years. The only significant difference in cQOL occurred at 0 to 5 years, where stereotactic radiation scores were better than both microsurgery and observation (P = .009). No significant differences were detected in cQOL after 5 years. Within the radiation group, cQOL was significantly lower at 6 to 10 years than at 0 to 5 years (P = .013). At no point was cQOL for stereotactic radiation less than that for observation or microsurgery.
Long-term (>5 years) quality-of-life outcomes measured by the PANQOL in vestibular schwannoma patients show no significant differences between stereotactic radiation, observation, and microsurgical intervention. Studies are needed to fully evaluate very-long-term QOL for patients with vestibular schwannoma.
比较接受观察、显微手术或立体定向放射治疗的前庭神经鞘瘤患者的长期生活质量结果。
采用回顾性病历审查的横断面调查。
三级医疗中心。
向600例接受前庭神经鞘瘤治疗的患者邮寄宾夕法尼亚听神经瘤生活质量（PANQOL）调查问卷。根据治疗方式对患者进行分组，随后再根据随访年限（0至5年、6至10年和大于10年）进行细分。计算生活质量综合评分（cQOL）以及听力、平衡、面神经、疼痛、焦虑、精力和总体健康状况的子评分。使用双尾方差分析和配对t检验，对各治疗组整体之间、每个时间间隔的治疗组之间以及各治疗组随时间的情况进行评分比较。
调查问卷回复率为49%，平均随访时间为7.9年。cQOL唯一的显著差异出现在0至5年，此时立体定向放射治疗的评分优于显微手术和观察治疗（P = .009）。5年后未检测到cQOL有显著差异。在放射治疗组中，6至10年的cQOL显著低于0至5年（P = .013）。立体定向放射治疗的cQOL在任何时候都不低于观察或显微手术治疗的cQOL。
PANQOL评估的前庭神经鞘瘤患者长期（>5年）生活质量结果显示，立体定向放射治疗、观察和显微手术干预之间无显著差异。需要开展研究以全面评估前庭神经鞘瘤患者的超长期生活质量。
