Does surgery change the effectiveness of radiation in vestibular Schwannoma?
Location
Medical Education Building, LSUHSC-NO
Presentation Date
10-10-2019 10:00 AM
End Date
10-10-2019 12:00 PM
Description
OBJECTIVE: This study compares tumor progression in a cohort of patients with unilateral vestibular schwannoma treated primarily with stereotactic radiotherapy versus a group treated with stereotactic radiotherapy after subtotal surgical resection and postoperative growth of residual tumor.
METHODS: This retrospective case-control study compared tumor progression in 20 adults treated with primary stereotactic radiotherapy (SRT) for growing vestibular schwannoma with tumor progression in 3 adults treated with stereotactic radiotherapy for growing vestibular schwannoma after primary subtotal resection (STR + SRT) between 2010 and 2019. Patients received fractionated radiotherapy of 18Gy in three divided doses. Tumor size was assessed with serial MRI scans. Tumor size progression of >2mm in the largest dimension after fractionated stereotactic radiotherapy was considered significant.
RESULTS: Mean age of patients in the SRT cohort was 72 years and 61 years in the STR + SRT group. The follow-up period for the SRT group was 75 months (range 36-72) versus 66 months (range 72-96) for the STR + SRT group. Tumor progression was observed more frequently in the STR + SRT group (66% versus 1%, p<0.05). Baseline tumor size in the SRT cohort was smaller (mean 7.6 x7.1mm versus 28 x 24mm).
CONCLUSIONS: Previously operated growing vestibular schwannoma demonstrated growth more frequently following stereotactic radiotherapy than previously untreated growing vestibular schwannoma. In addition to postoperative changes in the tumor biology, tumor size when radiated may be one of the predictors of tumor progression in this group. Additional research is needed to define other predictors for the relative efficacy of stereotactic radiotherapy in previously operated tumors before a planned STR-SRT treatment algorithm is widely adopted.
Recommended Citation
Jeha, George M. and Mankekar, Gauri MD, "Does surgery change the effectiveness of radiation in vestibular Schwannoma?" (2019). Medical Student Research Poster Symposium. 20.
https://digitalscholar.lsuhsc.edu/sommrd/2019/posters/20
Does surgery change the effectiveness of radiation in vestibular Schwannoma?
Medical Education Building, LSUHSC-NO
OBJECTIVE: This study compares tumor progression in a cohort of patients with unilateral vestibular schwannoma treated primarily with stereotactic radiotherapy versus a group treated with stereotactic radiotherapy after subtotal surgical resection and postoperative growth of residual tumor.
METHODS: This retrospective case-control study compared tumor progression in 20 adults treated with primary stereotactic radiotherapy (SRT) for growing vestibular schwannoma with tumor progression in 3 adults treated with stereotactic radiotherapy for growing vestibular schwannoma after primary subtotal resection (STR + SRT) between 2010 and 2019. Patients received fractionated radiotherapy of 18Gy in three divided doses. Tumor size was assessed with serial MRI scans. Tumor size progression of >2mm in the largest dimension after fractionated stereotactic radiotherapy was considered significant.
RESULTS: Mean age of patients in the SRT cohort was 72 years and 61 years in the STR + SRT group. The follow-up period for the SRT group was 75 months (range 36-72) versus 66 months (range 72-96) for the STR + SRT group. Tumor progression was observed more frequently in the STR + SRT group (66% versus 1%, p<0.05). Baseline tumor size in the SRT cohort was smaller (mean 7.6 x7.1mm versus 28 x 24mm).
CONCLUSIONS: Previously operated growing vestibular schwannoma demonstrated growth more frequently following stereotactic radiotherapy than previously untreated growing vestibular schwannoma. In addition to postoperative changes in the tumor biology, tumor size when radiated may be one of the predictors of tumor progression in this group. Additional research is needed to define other predictors for the relative efficacy of stereotactic radiotherapy in previously operated tumors before a planned STR-SRT treatment algorithm is widely adopted.
Comments
Mentor: Moises Arriaga MD, PhD, FACS