前庭神经鞘瘤放疗的近期管理：文献综述
The Recent Management of Vestibular Schwannoma Radiotherapy: A Narrative Review of the Literature.
作者信息
Brun Lucie, Mom Thierry, Guillemin Florent, Puechmaille Mathilde, Khalil Toufic, Biau Julian
机构信息
Department of Radiation Oncology, University Hospital of Lyon, 69002 Lyon, France.
Department of Otolaryngology-Head and Neck Surgery, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France.
出版信息
J Clin Med. 2024 Mar 11;13(6):1611. doi: 10.3390/jcm13061611.
BACKGROUND
Radiotherapy (RT) plays an important role in the therapeutic management of vestibular schwannoma (VS). Fractionated stereotactic radiotherapy (FSRT) or radiosurgery (SRS) are the two modalities available. The purpose of this article is to review the results of VS RT studies carried out over the last ten years.
MATERIALS AND METHODS
A literature search was performed with PubMed and Medline by using the words vestibular schwannoma, acoustic neuroma, radiotherapy, and radiosurgery.
RESULTS
In small (<3 cm) VS, SRS offers a local control rate of >90%, which seems similar to microsurgery, with a favorable tolerance profile. Hypofractionated FSRT (three to five fractions) is a relatively recent modality and has shown similar outcomes to normofractionated FSRT. Hearing preservation may highly differ between studies, but it is around 65% at 5 years.
CONCLUSIONS
SRS and FRST are non-invasive treatment options for VS. SRS is often preferred for small lesions less than 3 cm, and FSRT for larger lesions. However, no randomized study has compared these modalities.
背景
放射治疗（RT）在前庭神经鞘瘤（VS）的治疗管理中发挥着重要作用。分次立体定向放射治疗（FSRT）或放射外科手术（SRS）是两种可用的治疗方式。本文旨在回顾过去十年间VS放射治疗研究的结果。
材料与方法
使用PubMed和Medline数据库，以“前庭神经鞘瘤”“听神经瘤”“放射治疗”和“放射外科手术”为关键词进行文献检索。
结果
在小型（<3 cm）VS中，SRS的局部控制率>90%，这似乎与显微手术相似，且耐受性良好。大分割FSRT（三至五分次）是一种相对较新的治疗方式，其结果与常规分割FSRT相似。不同研究之间听力保留情况可能差异很大，但5年时约为65%。
结论
SRS和FSRT是VS的非侵入性治疗选择。对于小于3 cm的小病灶，通常首选SRS，对于较大病灶则首选FSRT。然而，尚无随机研究对这些治疗方式进行比较。
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