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散发性前庭神经鞘瘤立体定向放射治疗后疾病特异性生活质量变化的相关因素

Associations With Changes in Disease-Specific Quality of Life Following Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma.

作者信息

Babajanian Eric E, Daher Ghazal S, Dornhoffer James R, Khandalavala Karl R, Marinelli John P, Lohse Christine M, Link Michael J, Carlson Matthew L

机构信息

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Otolaryngol Head Neck Surg. 2025 Jul;173(1):201-207. doi: 10.1002/ohn.1243. Epub 2025 Apr 4.

Abstract

OBJECTIVE

To examine associations with changes in quality-of-life (QOL) outcomes following treatment of vestibular schwannoma (VS) using stereotactic radiosurgery (SRS).

STUDY DESIGN

Prospective longitudinal study.

SETTING

Tertiary academic center.

METHODS

Patients who were treated for sporadic VS using SRS from 2015 to 2022 were included. QOL outcomes were measured using the disease-specific Penn Acoustic Neuroma QOL (PANQOL) scale.

RESULTS

Seventy-nine patients with pre-SRS and at least one post-SRS PANQOL assessments were available for analysis. The mean change in total PANQOL scores was -2 (SD 13) on a 100-point scale. The mean duration between assessments was 4.6 years (SD 2.0). Age at SRS, sex, and SRS treatment doses were not significantly associated with changes in total PANQOL scores. Total PANQOL scores improved a mean of 4 points for patients with tumors confined to the internal auditory canal but declined a mean of 5 points for patients with tumors extending into the cerebellopontine angle (P = .01); however, these changes did not exceed the minimum clinically significant threshold of 11 points. The correlation coefficient between treated tumor volume at SRS and change in total PANQOL scores was -0.30 (P = .007). Changes in PANQOL total (P = .5) and hearing domain (P = .3) scores for patients who maintained serviceable hearing or progressed to nonserviceable hearing did not significantly differ.

CONCLUSION

Tumor extent and treated volume at SRS had a statistically significant but likely not clinically important impact on total PANQOL scores. Progression to nonserviceable hearing did not have a significant impact on PANQOL total or hearing domain scores.

摘要

目的

研究立体定向放射外科(SRS)治疗前庭神经鞘瘤(VS)后生活质量(QOL)结果的变化及其相关性。

研究设计

前瞻性纵向研究。

研究地点

三级学术中心。

方法

纳入2015年至2022年期间接受SRS治疗的散发性VS患者。使用特定疾病的宾夕法尼亚听神经瘤生活质量(PANQOL)量表测量生活质量结果。

结果

79例患者在SRS治疗前及至少一次SRS治疗后进行了PANQOL评估,可供分析。在100分制量表上,PANQOL总分的平均变化为-2(标准差13)。评估之间的平均时间间隔为4.6年(标准差2.0)。SRS治疗时的年龄、性别和SRS治疗剂量与PANQOL总分的变化无显著相关性。局限于内耳道的肿瘤患者,PANQOL总分平均提高4分;而肿瘤延伸至桥小脑角的患者,PANQOL总分平均下降5分(P = 0.01);然而,这些变化未超过临床上有意义的最小阈值11分。SRS治疗时的肿瘤体积与PANQOL总分变化之间的相关系数为-0.30(P = 0.007)。听力保持良好或进展为听力丧失的患者,PANQOL总分(P = 0.5)和听力领域得分(P = 0.3)的变化无显著差异。

结论

SRS治疗时的肿瘤范围和治疗体积对PANQOL总分有统计学上的显著影响,但可能在临床上并不重要。进展为听力丧失对PANQOL总分或听力领域得分无显著影响。

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