Movsas Shoshana, Hefferly Michael, Movsas Benjamin, Shafiro Valeriy
Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
J Radiosurg SBRT. 2014;3(1):13-20.
The purpose of this systematic review was to compare, from an audiological perspective, hearing preservation rates after fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) for patients with vestibular schwannomas (VS). A literature review was conducted via Pubmed with the following phrases: radiosurgery, fractionated radiotherapy, vestibular schwannoma and hearing. Of 57 studies identified, six were included in the analysis based on the inclusion and exclusion factors. Tumor control rates were excellent (>90%) for both treatment options. Regarding hearing preservation, three of the six articles reported a significant advantage of FSRT over SRS, while the other three did not find significant differences. The FSRT method may result in higher hearing preservation in selected clinical settings: larger tumors (>3cc), age >55 years, and/or when the SRS dose prescribed was >13 Gy. However, as limitations exist and these studies were not randomized, further studies are needed which incorporate hearing outcomes using enhanced tools. This systematic review can help physicians and patients make more informed decisions regarding radiation treatment options for VS.
本系统评价的目的是从听力学角度比较前庭神经鞘瘤（VS）患者接受分次立体定向放射治疗（FSRT）和立体定向放射外科治疗（SRS）后的听力保留率。通过PubMed以“放射外科、分次放射治疗、前庭神经鞘瘤和听力”等短语进行文献检索。在检索到的57项研究中，根据纳入和排除标准，有6项被纳入分析。两种治疗方案的肿瘤控制率均极佳（>90%）。关于听力保留，6篇文章中有3篇报道FSRT相对于SRS具有显著优势，而另外3篇未发现显著差异。FSRT方法在某些特定临床情况下可能会带来更高的听力保留率，如肿瘤较大（>3cc）、年龄>55岁和/或当规定的SRS剂量>13 Gy时。然而，由于存在局限性且这些研究并非随机对照研究，因此需要进一步开展研究，采用更先进的工具纳入听力结果评估。本系统评价有助于医生和患者就VS的放射治疗方案做出更明智的决策。
