Mahboubi Hossein, Sahyouni Ronald, Moshtaghi Omid, Tadokoro Kent, Ghavami Yaser, Ziai Kasra, Lin Harrison W, Djalilian Hamid R
1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA.
2 Department of Biomedical Engineering, University of California, Irvine, California, USA.
Otolaryngol Head Neck Surg. 2017 Jul;157(1):7-15. doi: 10.1177/0194599817695805. Epub 2017 Apr 25.
Objectives (1) Perform a meta-analysis of the available data on the outcomes of CyberKnife radiosurgery for treatment of vestibular schwannomas (VSs) in the published English-language literature and (2) evaluate the collective outcomes of CyberKnife treatment with respect to tumor control and hearing preservation. Data Sources A thorough literature search of published English-language articles was performed in the PubMed, Ovid, and Cochrane databases. Review Methods A database search was conducted with the keywords "CyberKnife" and "vestibular schwannoma" or "acoustic neuroma." A total of 25 papers were found and reviewed. Data were extracted for patient demographics, number of patients with neurofibromatosis type 2, pretreatment hearing status, tumor size, margin dose, and follow-up duration. The primary outcome variables evaluated were tumor control and hearing preservation. Results After careful review of the published articles, 11 papers reported data on outcomes of CyberKnife treatment for VS and were included in the analysis, comprising 800 patients studied during 1998 to 2012. The reported mean tumor volume ranged from 0.02 to 19.8 cm, and the follow-up duration ranged from 6 to 120 months. Margin dose varied from 14 to 25 Gy. The collective mean tumor control rate was 96.3% (95% CI: 94.0%-98.5%). The collective hearing preservation rate was 79.1% (95% CI: 71.0%-87.3%) in 427 patients with measurable hearing. Conclusion Clinical data on outcomes of CyberKnife radiosurgery for treatment of VSs are sparse and primarily limited to single-institution analyses, with considerable variation in tumor volume and follow-up time. This meta-analysis not only provides an in-depth analysis of available data in the literature but also reviews reported outcomes and complications.
（1）对已发表的英文文献中关于射波刀放射外科治疗前庭神经鞘瘤（VSs）的结果进行荟萃分析；（2）评估射波刀治疗在肿瘤控制和听力保留方面的总体结果。数据来源：在PubMed、Ovid和Cochrane数据库中对已发表的英文文章进行全面的文献检索。综述方法：使用关键词“射波刀”和“前庭神经鞘瘤”或“听神经瘤”进行数据库检索。共找到并审阅了25篇论文。提取了患者人口统计学数据、2型神经纤维瘤病患者数量、治疗前听力状况、肿瘤大小、边缘剂量和随访时间的数据。评估的主要结局变量为肿瘤控制和听力保留。结果：在仔细审阅已发表的文章后，11篇论文报告了射波刀治疗VS的结果，并纳入分析，包括1998年至2012年期间研究的800例患者。报告的平均肿瘤体积为0.02至19.8 cm，随访时间为6至120个月。边缘剂量为14至25 Gy。总体平均肿瘤控制率为96.3%（95%CI：94.0%-98.5%）。427例有可测量听力的患者的总体听力保留率为79.1%（95%CI：71.0%-87.3%）。结论：关于射波刀放射外科治疗VS结果的临床数据稀少，主要限于单机构分析，肿瘤体积和随访时间差异较大。这项荟萃分析不仅对文献中的现有数据进行了深入分析，还回顾了报告的结果和并发症。
