Singh Raj, Ansinelli Hayden, Jenkins Jan, Davis Joanne, Sharma Sanjeev, Vargo John Austin
Virginia Commonwealth University, Department of Radiation Oncology, Richmond, VA 23298, USA.
The Radiosurgery Society, Sunnyvale, CA 94402, USA.
J Radiosurg SBRT. 2019;6(1):19-26.
To compare clinical outcomes following stereotactic radiosurgery (SRS) and fractionated stereotactic radiosurgery (fSRS) for vestibular schwannomas (VS).
MATERIALS/METHODS: We identified 64 VS patients from the RSSearch Patient Registry (12 treated with SRS and 52 patients treated with fSRS). Potential factors predictive of local control (LC) and toxicity were estimated using the Kaplan-Meier method, Cox proportional hazards model, and binary logistic regressions with propensity score weighting.
SRS (100%) and fSRS (94.2%) resulted in similar LC (p = 0.33). fSRS was associated with a higher likelihood of experiencing toxicities (42.3% vs. 8.3%; p = 0.054 on time-to-event analysis) that was maintained following a propensity-score weighted binary logistic regression (p = 0.037) and propensity-score weighted Cox regression (p = 0.039; hazard ratio (HR) = 8.85 (95% CI: 1.1 - 70.1)).
In a multi-institutional analysis, we note equivalent LC but higher toxicity with fSRS compared to SRS for VS.
比较立体定向放射外科治疗（SRS）和分次立体定向放射外科治疗（fSRS）用于前庭神经鞘瘤（VS）后的临床结果。
材料/方法：我们从RSSearch患者登记处识别出64例VS患者（12例接受SRS治疗，52例接受fSRS治疗）。使用Kaplan-Meier法、Cox比例风险模型以及倾向评分加权的二元逻辑回归来评估预测局部控制（LC）和毒性的潜在因素。
SRS（100%）和fSRS（94.2%）的局部控制率相似（p = 0.33）。fSRS出现毒性反应的可能性更高（42.3%对8.3%；事件发生时间分析中p = 0.054），在倾向评分加权二元逻辑回归（p = 0.037）和倾向评分加权Cox回归（p = 0.039；风险比（HR）= 8.85（95% CI：1.1 - 70.1））后该结果依然成立。
在一项多机构分析中，我们注意到对于VS，与SRS相比，fSRS的局部控制率相当，但毒性更高。
