Outcomes After Stereotactic Radiosurgery for Vestibular Schwannoma

Background: Patients with vestibular schwannoma are often treated with stereotactic radiosurgery (SRS) as an alternative to microsurgical resection or observation. Rates of failure after SRS remain unknown. The objective of this study was to determine the need for additional SRS or microsurgical resection after initial SRS for vestibular schwannoma, using the TriNetX Research Network, a global health research network.

Methods: A cohort of patients aged 18 years and over was identified using the TriNetX Research Network database. Patients were selected who had diagnoses of benign neoplasm of cranial nerve (ICD-10 code D33.3) and conductive or sensorineural hearing loss (ICD-10 code H90), without a diagnosis of neurofibromatosis type 2 (ICD-10 code Q85.02), and who had undergone SRS (CPT code 61798) between 2003 and 2023. SRS was set as the index event, and the cohort was analyzed for outcomes of additional SRS and skull base microsurgical resection (CPT codes 61616, 6159x) at any time after the index event.

Results: A total of 861 patients were identified in the cohort, which was 44% male, 56% female, and 86% white. Ages ranged from 18 to 90 years; mean age was 68 with a standard deviation of 13. Of these patients, 23 (2.79%) underwent subsequent SRS, and 29 (3.37%) underwent subsequent microsurgery. Overall, 52 patients (6.04%) required additional treatment with either SRS or microsurgery after initial SRS.

Conclusions: After treatment with SRS for vestibular schwannoma, 93.96% of patients did not require additional treatment with SRS or microsurgery.

 

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Artikel online veröffentlicht:
05. Februar 2024