Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study
Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of t...
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| Veröffentlicht in: | World neurosurgery 2023-10, Vol.178, p.e24-e33 |
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| creator | Chang, Steven D. Muacevic, Alexander Klein, Andrea L. Sherman, Jonathan H. Romanelli, Pantaleo Santa Maria, Peter L. Fuerweger, Christoph Bossi Zanetti, Isa Beltramo, Giancarlo Vaisbush, Yona Tran, Emma Feng, Austin Teng, Hao Meola, Antonio Gibbs, Iris Tolisano, Antony M. Kutz, Joe Walter Wardak, Zabi Nedzi, Lucien A. Hong, Robert MacRae, Don Sohal, Preet Kapoor, Elina Sabet-Rasekh, Parisa Maghami, Sam Moncada, Paola X. Zaleski-King, Ashley Amdur, Richard Monfared, Ashkan |
| description | Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration.
Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990–2020 and had pre- and post-treatment audiograms.
Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12–60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS.
Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing. |
| doi_str_mv | 10.1016/j.wneu.2023.05.098 |
| format | Article |
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Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990–2020 and had pre- and post-treatment audiograms.
Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12–60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS.
Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.</description><identifier>ISSN: 1878-8750</identifier><identifier>ISSN: 1878-8769</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2023.05.098</identifier><identifier>PMID: 37268187</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Follow-Up Studies ; Fractionation ; Hearing ; Hearing preservation ; Humans ; Neuroma, Acoustic - radiotherapy ; Neuroma, Acoustic - surgery ; Radiation dose ; Radiosurgery - adverse effects ; Radiosurgery - methods ; Retrospective Studies ; Stereotactic radiosurgery ; Treatment Outcome ; Vestibular schwannoma</subject><ispartof>World neurosurgery, 2023-10, Vol.178, p.e24-e33</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-9cc0173b9fa5fa3cdb5595d6d8d4b0ddcffac4d1ea34700677134f20aa36b2c3</cites><orcidid>0000-0003-1372-1774 ; 0000-0002-0908-9166 ; 0000-0003-4146-3493 ; 0000-0001-8240-8330 ; 0000-0003-0682-5452 ; 0000-0001-9482-3988 ; 0000-0003-2426-2884 ; 0000-0001-6756-4749</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.wneu.2023.05.098$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37268187$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Steven D.</creatorcontrib><creatorcontrib>Muacevic, Alexander</creatorcontrib><creatorcontrib>Klein, Andrea L.</creatorcontrib><creatorcontrib>Sherman, Jonathan H.</creatorcontrib><creatorcontrib>Romanelli, Pantaleo</creatorcontrib><creatorcontrib>Santa Maria, Peter L.</creatorcontrib><creatorcontrib>Fuerweger, Christoph</creatorcontrib><creatorcontrib>Bossi Zanetti, Isa</creatorcontrib><creatorcontrib>Beltramo, Giancarlo</creatorcontrib><creatorcontrib>Vaisbush, Yona</creatorcontrib><creatorcontrib>Tran, Emma</creatorcontrib><creatorcontrib>Feng, Austin</creatorcontrib><creatorcontrib>Teng, Hao</creatorcontrib><creatorcontrib>Meola, Antonio</creatorcontrib><creatorcontrib>Gibbs, Iris</creatorcontrib><creatorcontrib>Tolisano, Antony M.</creatorcontrib><creatorcontrib>Kutz, Joe Walter</creatorcontrib><creatorcontrib>Wardak, Zabi</creatorcontrib><creatorcontrib>Nedzi, Lucien A.</creatorcontrib><creatorcontrib>Hong, Robert</creatorcontrib><creatorcontrib>MacRae, Don</creatorcontrib><creatorcontrib>Sohal, Preet</creatorcontrib><creatorcontrib>Kapoor, Elina</creatorcontrib><creatorcontrib>Sabet-Rasekh, Parisa</creatorcontrib><creatorcontrib>Maghami, Sam</creatorcontrib><creatorcontrib>Moncada, Paola X.</creatorcontrib><creatorcontrib>Zaleski-King, Ashley</creatorcontrib><creatorcontrib>Amdur, Richard</creatorcontrib><creatorcontrib>Monfared, Ashkan</creatorcontrib><title>Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><description>Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration.
Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990–2020 and had pre- and post-treatment audiograms.
Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12–60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS.
Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.</description><subject>Follow-Up Studies</subject><subject>Fractionation</subject><subject>Hearing</subject><subject>Hearing preservation</subject><subject>Humans</subject><subject>Neuroma, Acoustic - radiotherapy</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Radiation dose</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiosurgery - methods</subject><subject>Retrospective Studies</subject><subject>Stereotactic radiosurgery</subject><subject>Treatment Outcome</subject><subject>Vestibular schwannoma</subject><issn>1878-8750</issn><issn>1878-8769</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EolXpC7BAXrJJ8E8SO4hNNaW0UhGIjthajn3TepTYg-10NG_BI-NhSpd4c-3r7xz5-iD0lpKaEtp92NQ7D0vNCOM1aWvSyxfolEohKym6_uXzviUn6DylDSmL00YK_hqdcME6WYBT9Ptm3mqTcRjxKpiHCXTElyEBDh5fl4Pz9_h7hATxUWdXmldhmsLu0L7LECHkonYG_9DWhbTEe4h77DxeR9B5Bv_X-Sek7IZlKt535mGnvQ-zTh_xBf66TNlVq8JBucuL3b9Br0Y9JTh_qmdoffV5vbqubr99uVld3FaGE5Gr3hhCBR_6Ubej5sYObdu3trPSNgOx1oyjNo2loHkjCOmEoLwZGdGadwMz_Ay9P9puY_i1lPep2SUD06Q9hCUpJhnjkhAhC8qOqIkhpQij2kY367hXlKhDFmqjDlmoQxaKtKpkUUTvnvyXYQb7LPn38wX4dASgDPnoIKpkHHgD1kUwWdng_uf_ByXMniM</recordid><startdate>202310</startdate><enddate>202310</enddate><creator>Chang, Steven D.</creator><creator>Muacevic, Alexander</creator><creator>Klein, Andrea L.</creator><creator>Sherman, Jonathan H.</creator><creator>Romanelli, Pantaleo</creator><creator>Santa Maria, Peter L.</creator><creator>Fuerweger, Christoph</creator><creator>Bossi Zanetti, Isa</creator><creator>Beltramo, Giancarlo</creator><creator>Vaisbush, Yona</creator><creator>Tran, Emma</creator><creator>Feng, Austin</creator><creator>Teng, Hao</creator><creator>Meola, Antonio</creator><creator>Gibbs, Iris</creator><creator>Tolisano, Antony M.</creator><creator>Kutz, Joe Walter</creator><creator>Wardak, Zabi</creator><creator>Nedzi, Lucien A.</creator><creator>Hong, Robert</creator><creator>MacRae, Don</creator><creator>Sohal, Preet</creator><creator>Kapoor, Elina</creator><creator>Sabet-Rasekh, Parisa</creator><creator>Maghami, Sam</creator><creator>Moncada, Paola X.</creator><creator>Zaleski-King, Ashley</creator><creator>Amdur, Richard</creator><creator>Monfared, Ashkan</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1372-1774</orcidid><orcidid>https://orcid.org/0000-0002-0908-9166</orcidid><orcidid>https://orcid.org/0000-0003-4146-3493</orcidid><orcidid>https://orcid.org/0000-0001-8240-8330</orcidid><orcidid>https://orcid.org/0000-0003-0682-5452</orcidid><orcidid>https://orcid.org/0000-0001-9482-3988</orcidid><orcidid>https://orcid.org/0000-0003-2426-2884</orcidid><orcidid>https://orcid.org/0000-0001-6756-4749</orcidid></search><sort><creationdate>202310</creationdate><title>Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study</title><author>Chang, Steven D. ; Muacevic, Alexander ; Klein, Andrea L. ; Sherman, Jonathan H. ; Romanelli, Pantaleo ; Santa Maria, Peter L. ; Fuerweger, Christoph ; Bossi Zanetti, Isa ; Beltramo, Giancarlo ; Vaisbush, Yona ; Tran, Emma ; Feng, Austin ; Teng, Hao ; Meola, Antonio ; Gibbs, Iris ; Tolisano, Antony M. ; Kutz, Joe Walter ; Wardak, Zabi ; Nedzi, Lucien A. ; Hong, Robert ; MacRae, Don ; Sohal, Preet ; Kapoor, Elina ; Sabet-Rasekh, Parisa ; Maghami, Sam ; Moncada, Paola X. ; Zaleski-King, Ashley ; Amdur, Richard ; Monfared, Ashkan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-9cc0173b9fa5fa3cdb5595d6d8d4b0ddcffac4d1ea34700677134f20aa36b2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Follow-Up Studies</topic><topic>Fractionation</topic><topic>Hearing</topic><topic>Hearing preservation</topic><topic>Humans</topic><topic>Neuroma, Acoustic - radiotherapy</topic><topic>Neuroma, Acoustic - surgery</topic><topic>Radiation dose</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiosurgery - methods</topic><topic>Retrospective Studies</topic><topic>Stereotactic radiosurgery</topic><topic>Treatment Outcome</topic><topic>Vestibular schwannoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Steven D.</creatorcontrib><creatorcontrib>Muacevic, Alexander</creatorcontrib><creatorcontrib>Klein, Andrea L.</creatorcontrib><creatorcontrib>Sherman, Jonathan H.</creatorcontrib><creatorcontrib>Romanelli, Pantaleo</creatorcontrib><creatorcontrib>Santa Maria, Peter L.</creatorcontrib><creatorcontrib>Fuerweger, Christoph</creatorcontrib><creatorcontrib>Bossi Zanetti, Isa</creatorcontrib><creatorcontrib>Beltramo, Giancarlo</creatorcontrib><creatorcontrib>Vaisbush, Yona</creatorcontrib><creatorcontrib>Tran, Emma</creatorcontrib><creatorcontrib>Feng, Austin</creatorcontrib><creatorcontrib>Teng, Hao</creatorcontrib><creatorcontrib>Meola, Antonio</creatorcontrib><creatorcontrib>Gibbs, Iris</creatorcontrib><creatorcontrib>Tolisano, Antony M.</creatorcontrib><creatorcontrib>Kutz, Joe Walter</creatorcontrib><creatorcontrib>Wardak, Zabi</creatorcontrib><creatorcontrib>Nedzi, Lucien A.</creatorcontrib><creatorcontrib>Hong, Robert</creatorcontrib><creatorcontrib>MacRae, Don</creatorcontrib><creatorcontrib>Sohal, Preet</creatorcontrib><creatorcontrib>Kapoor, Elina</creatorcontrib><creatorcontrib>Sabet-Rasekh, Parisa</creatorcontrib><creatorcontrib>Maghami, Sam</creatorcontrib><creatorcontrib>Moncada, Paola X.</creatorcontrib><creatorcontrib>Zaleski-King, Ashley</creatorcontrib><creatorcontrib>Amdur, Richard</creatorcontrib><creatorcontrib>Monfared, Ashkan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>World neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Steven D.</au><au>Muacevic, Alexander</au><au>Klein, Andrea L.</au><au>Sherman, Jonathan H.</au><au>Romanelli, Pantaleo</au><au>Santa Maria, Peter L.</au><au>Fuerweger, Christoph</au><au>Bossi Zanetti, Isa</au><au>Beltramo, Giancarlo</au><au>Vaisbush, Yona</au><au>Tran, Emma</au><au>Feng, Austin</au><au>Teng, Hao</au><au>Meola, Antonio</au><au>Gibbs, Iris</au><au>Tolisano, Antony M.</au><au>Kutz, Joe Walter</au><au>Wardak, Zabi</au><au>Nedzi, Lucien A.</au><au>Hong, Robert</au><au>MacRae, Don</au><au>Sohal, Preet</au><au>Kapoor, Elina</au><au>Sabet-Rasekh, Parisa</au><au>Maghami, Sam</au><au>Moncada, Paola X.</au><au>Zaleski-King, Ashley</au><au>Amdur, Richard</au><au>Monfared, Ashkan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study</atitle><jtitle>World neurosurgery</jtitle><addtitle>World Neurosurg</addtitle><date>2023-10</date><risdate>2023</risdate><volume>178</volume><spage>e24</spage><epage>e33</epage><pages>e24-e33</pages><issn>1878-8750</issn><issn>1878-8769</issn><eissn>1878-8769</eissn><abstract>Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration.
Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990–2020 and had pre- and post-treatment audiograms.
Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12–60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS.
Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37268187</pmid><doi>10.1016/j.wneu.2023.05.098</doi><orcidid>https://orcid.org/0000-0003-1372-1774</orcidid><orcidid>https://orcid.org/0000-0002-0908-9166</orcidid><orcidid>https://orcid.org/0000-0003-4146-3493</orcidid><orcidid>https://orcid.org/0000-0001-8240-8330</orcidid><orcidid>https://orcid.org/0000-0003-0682-5452</orcidid><orcidid>https://orcid.org/0000-0001-9482-3988</orcidid><orcidid>https://orcid.org/0000-0003-2426-2884</orcidid><orcidid>https://orcid.org/0000-0001-6756-4749</orcidid></addata></record> |
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| subjects | Follow-Up Studies Fractionation Hearing Hearing preservation Humans Neuroma, Acoustic - radiotherapy Neuroma, Acoustic - surgery Radiation dose Radiosurgery - adverse effects Radiosurgery - methods Retrospective Studies Stereotactic radiosurgery Treatment Outcome Vestibular schwannoma |
| title | Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study |
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