Department of Otorhinolaryngology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Dutch Academic Alliance Skull Base Pathology, Radboud University Medical Center, Maastricht University Medical Center+, Nijmegen/Maastricht, The Netherlands.
Otolaryngol Head Neck Surg. 2024 Sep;171(3):823-832. doi: 10.1002/ohn.814. Epub 2024 May 20.
To assess the effect of wait and scan (W&S) and stereotactic radiosurgery (SRS) on health-related quality of life (HRQoL) over time in patients with a stable vestibular schwannoma (VS) and growing VS.
Longitudinal, multicenter, observational study.
Tertiary expert center for VS (Radboudumc Nijmegen) and Gamma-Knife center ETZ Hospital Tilburg.
Changes in HRQoL, measured with the Penn Acoustic Neuroma Quality-of-Life (PANQOL), and the physical and mental component summary scores (PCS and MCS, respectively) derived from the 36-Item Short Form Health Survey (SF-36), were compared among patients managed by W&S and SRS between 2017 and 2022. Second, HRQoL over time in patients with a growing VS was compared between W&S and SRS.
Differences in PANQOL total and subdomain scores, PCS and MCS scores over time in the W&S (n = 73) and SRS (n = 170) groups were nonsignificant and on average did not exceed the minimal clinically important differences (mean difference of -2.56 [PANQOL total], 1.22 [PCS], and -1.76 [MCS]; all P > .05). In growing VS, comparison of W&S (n = 29) and SRS (n = 154) also revealed no significant difference (mean difference of 1.19 (PANQOL total), 1.83 (PCS) and -0.12 (MCS); all P > .05).
Differences in HRQoL in patients with VS are minor and not significantly different or clinically relevant between patients managed with W&S or SRS. Similarly, patients with a growing VS managed with W&S or SRS exhibit no significant or clinical relevant difference in HRQoL during follow-up. This can aid clinicians in the counseling of patients regarding HRQoL when deciding on a management strategy after diagnosis or documented growth.
评估在稳定听神经瘤（VS）和生长性 VS 患者中，采用等待和扫描（W&S）与立体定向放射外科（SRS）治疗对健康相关生活质量（HRQoL）的长期影响。
纵向、多中心、观察性研究。
VS 三级专家中心（Radboudumc Nijmegen）和 Gamma-Knife 中心 ETZ 医院蒂尔堡。
采用宾夕法尼亚听神经瘤生活质量量表（PANQOL）和 36 项简明健康调查量表（SF-36）衍生的身体和精神成分综合评分（PCS 和 MCS）评估 2017 年至 2022 年间 W&S 和 SRS 治疗的患者 HRQoL 变化。其次，比较生长性 VS 患者中 W&S 和 SRS 之间的 HRQoL 随时间的变化。
W&S（n=73）和 SRS（n=170）组之间 PANQOL 总分和各亚域评分、PCS 和 MCS 评分的差异无统计学意义，平均差异均未超过最小临床重要差异（平均差值分别为 -2.56[PANQOL 总分]、1.22[PCS]和 -1.76[MCS]；均 P>.05）。在生长性 VS 中，W&S（n=29）和 SRS（n=154）的比较也未显示出显著差异（平均差值分别为 1.19[PANQOL 总分]、1.83[PCS]和 -0.12[MCS]；均 P>.05）。
VS 患者的 HRQoL 差异较小，且在 W&S 或 SRS 治疗患者之间无显著差异或无临床相关性。同样，在随访期间，采用 W&S 或 SRS 治疗生长性 VS 的患者 HRQoL 无显著或临床相关差异。这有助于临床医生在诊断后或有生长记录时，在决定管理策略时为患者提供有关 HRQoL 的咨询。
