CyberKnife-Based Stereotactic Radiosurgery for Vestibular Schwannoma: Meta-Analysis of Long-Term Tumor Control and Hearing Preservation Outcomes

Introduction: In the present study, we systematically review the extant literature describing CyberKnife radiosurgery (CKRS) as treatment for vestibular schwannoma (VS). We then perform pooled meta-analysis of long-term tumor control and hearing preservation rates reported across all retrospective observational series describing the efficacy of CKRS.

Methods: We queried the PubMed, Scopus, and Web of Science databases in order to identify all primary retrospective studies reporting local tumor control and hearing preservation rates following CKRS for treatment of vestibular schwannoma. All studies returned across the three databases were subject to systematic screen according to predefined inclusion and exclusion criteria in a multi-step process performed by two investigators.

Results: Following a comprehensive systematic search, a total of 15 studies comprising 2,018 vestibular schwannoma patients were included. Pooled rate of tumor control using the random effects model was 96% (95% CI: 95–98%), and that of hearing preservation was 73% (95% CI: 66–81%). The most common major complications following CKRS were trigeminal neuralgia, facial neuropathy, and hydrocephalus.

Conclusions: As studies on CyberKnife radiosurgery, one of the SRS modalities administered via LINAC, are far less common than studies on Gamma Knife radiosurgery for treatment of VS, more studies are needed in order to solidify the findings reported in the present meta-analysis. Although there are currently only 15 single-institution retrospective studies available in the neurosurgical literature, this study provides the most comprehensive and up-to-date analysis of highly relevant outcomes of interest in treatment of vestibular schwannoma via CyberKnife.

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Artikel online veröffentlicht:
05. Februar 2024