Department of Neurosurgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.
Department of Head and Neck Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.
Clin Neurol Neurosurg. 2020 Jan;188:105571. doi: 10.1016/j.clineuro.2019.105571. Epub 2019 Oct 31.
The use of SRS for treatment of cystic vestibular schwannoma is a topic of mild controversy. This review serves to introduce a renewed understanding of the efficacy of SRS as a viable treatment modality for cystic VS.
This study was conducted in accordance with the PRISMA guidelines. A broad search of the literature was conducted in October 2018 through the PubMed, Scopus, Embase, Web of Science, and Cochrane databases. Meta-analysis was conducted on tumor control rates and heterogeneity between articles was assessed using τ, Cochran's Q, and I statistics.
A total of 246 patients underwent SRS for cystic VS, with reported mean or median follow-up ranging from 49.7 to 150 months, and an overall range of 6-201 months. Following SRS treatment for cystic VS across all studies, 92% of patients had tumor control at follow up, (95%-CI: 88-95%). Tumor control rate specifically for patients who underwent GammaKnife was 93% (95-CI: 88%-95%).
Despite the paucity of pertinent data, the results of our meta-analysis suggest that SRS exhibits effective tumor control rates in patients with cystic VS. Therefore, SRS can be considered a viable treatment modality when choosing amongst interventions for cystic VS.
使用 SRS 治疗囊性前庭神经鞘瘤是一个存在一定争议的话题。本综述旨在重新认识 SRS 作为囊性 VS 可行治疗方法的疗效。
本研究遵循 PRISMA 指南进行。于 2018 年 10 月在 PubMed、Scopus、Embase、Web of Science 和 Cochrane 数据库中进行了广泛的文献检索。对肿瘤控制率进行了荟萃分析，并使用τ、Cochran's Q 和 I 统计量评估了文章之间的异质性。
共有 246 例囊性 VS 患者接受了 SRS 治疗，报道的中位或平均随访时间为 49.7 至 150 个月，范围为 6 至 201 个月。在所有研究中，囊性 VS 患者接受 SRS 治疗后，92%的患者在随访时肿瘤得到控制（95%可信区间：88-95%）。接受伽玛刀治疗的患者肿瘤控制率为 93%（95%可信区间：88%-95%）。
尽管相关数据有限，但我们的荟萃分析结果表明，SRS 对囊性 VS 患者具有有效的肿瘤控制率。因此，在选择囊性 VS 的干预措施时，可以考虑 SRS 作为一种可行的治疗方法。
