Rykaczewski Bartosz, Zabek Miroslaw
Mazovia Regional Hospital, Warsaw, Poland.
Department of Neurosurgery, Postgraduate Medical Center, Brodno Mazovia Hospital, Warsaw, Poland.
Contemp Oncol (Pozn). 2014;18(1):60-6. doi: 10.5114/wo.2014.39840. Epub 2014 Jan 25.
One of the alternative methods of surgical treatment of vestibular schwannoma is Gamma Knife radiosurgery. The purpose of this metaanalysis was to analyze the progress in treatment of vestibular schwannoma using Gamma Knife radiosurgery based on data in the literature of the last five years.
In the collected English-language literature from the years 2007-2011, contained in 20 scientific journals, clinical articles of many years study at a single center were extracted and also review papers and case reports. The main criteria of our own analysis were: patient age, tumor size, the dose in Gy, the time from surgery to follow-up, the degree of tumor growth inhibition, and hearing preservation. For statistical calculations comparing series of studies we used nonparametric analysis of variance and tests at the significance level of p > 0.05.
The 46 evaluated clinical articles show the results of studies over many years. A comparison of the results of the analysis made on the basis of papers published in the period 1998-2007 with the results of the current series from the period 2007-2011 allowed us to establish that the average dose applied to the periphery of the tumor was lower (12.4 Gy) than in the earlier series of 1998-2007 (14.2 Gy), and hearing preservation was higher (66.45% vs. 51.0%).
Clinical findings widely documented in the literature over the past five years indicate the progress in treatment of vestibular schwannoma using Gamma Knife radiosurgery.
前庭神经鞘瘤手术治疗的替代方法之一是伽玛刀放射外科手术。本荟萃分析的目的是基于过去五年的文献数据,分析使用伽玛刀放射外科手术治疗前庭神经鞘瘤的进展。
从20种科学期刊收集的2007 - 2011年英文文献中,提取了单中心多年研究的临床文章以及综述论文和病例报告。我们自身分析的主要标准为:患者年龄、肿瘤大小、以Gy为单位的剂量、手术至随访的时间、肿瘤生长抑制程度以及听力保留情况。对于比较系列研究的统计计算,我们使用了非参数方差分析以及显著性水平为p > 0.05的检验。
46篇评估的临床文章展示了多年研究的结果。将基于1998 - 2007年发表论文的分析结果与2007 - 2011年当前系列的结果进行比较,我们发现应用于肿瘤周边的平均剂量低于1998 - 2007年早期系列(分别为12.4 Gy和14.2 Gy),且听力保留率更高(分别为66.45%和51.0%)。
过去五年文献中广泛记录的临床研究结果表明,使用伽玛刀放射外科手术治疗前庭神经鞘瘤取得了进展。