Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Department of Otorhinolaryngology - Head and Neck Surgery, Hospitals of the University of Pennsylvania.
Otol Neurotol. 2019 Sep;40(8):1094-1100. doi: 10.1097/MAO.0000000000002334.
To examine quality of life changes for patients with vestibular schwannoma (VS) undergoing observation or stereotactic radiosurgery (SRS).
Retrospective review.
Academic medical center.
Patients with VS who underwent observation or SRS and had at least two audiograms and Penn Acoustic Neuroma Quality of Life (PANQOL) surveys, a quality of life survey for patients with VS.
SRS or observation.
Pure-tone average (PTA), speech discrimination score (SDS), PANQOL score; controlling for tumor size, baseline hearing, and other factors.
One hundred twenty-three patients met inclusion criteria: 89 underwent observation and 34 SRS. There was no significant difference in the rate of decline measured by PTA (PTA worsened at a rate of 0.25 dB/yr more in the observation group compared with the SRS group, p = 0.77) and SDS (SDS worsened at a rate of 2.1%/yr more in the SRS group compared with the observation group, p = 0.82). Kaplan-Meier analysis demonstrated the SRS group had a higher probability to progress to class D hearing over observation (hazard ratio 7.1, p = 0.005). The rate of change of the SRS PANQOL scores was significantly improved in the total (p = 0.005) and hearing (p = 0.04) domain score compared with observation. However, both groups regress to a similar PANQOL total and hearing domain score over time.
PANQOL scores were higher at baseline in the observation group than in the SRS group. However, over time, PANQOL scores in the observation group decreased while PANQOL scores in the SRS group increased, resulting in PANQOL scores that were equivalent by the end of follow-up.
研究行观察或立体定向放射外科（SRS）治疗的前庭神经鞘瘤（VS）患者的生活质量变化。
回顾性研究。
学术医疗中心。
行观察或 SRS 治疗且至少有 2 次纯音听阈测试和宾夕法尼亚听神经瘤生活质量（PANQOL）调查的 VS 患者，该调查为 VS 患者的生活质量调查。
SRS 或观察。
纯音听阈平均值（PTA）、言语辨别率（SDS）、PANQOL 评分；控制肿瘤大小、基线听力和其他因素。
123 例患者符合纳入标准：89 例行观察，34 例行 SRS。PTA （观察组较 SRS 组每年恶化 0.25dB，p=0.77）和 SDS （SRS 组较观察组每年恶化 2.1%，p=0.82）的下降率无显著差异。Kaplan-Meier 分析表明 SRS 组进展为 D 级听力的可能性高于观察组（风险比 7.1，p=0.005）。SRS 组的 PANQOL 总分（p=0.005）和听力（p=0.04）评分较观察组改善。然而，两组的 PANQOL 总分和听力评分随时间推移均有回归。
观察组的 PANQOL 评分基线高于 SRS 组。然而，随着时间的推移，观察组的 PANQOL 评分下降，而 SRS 组的 PANQOL 评分升高，导致随访结束时两组的 PANQOL 评分相当。
