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A systematic review and meta-analysis of stereotactic radiosurgery as a primary treatment in fast-growing vestibular schwannomas

Published online by Cambridge University Press:  17 May 2023

Faizan Shah ,
Leanne O W Hamilton ,
Constantina P Yiannakis ,
Mohd Afiq Mohd Slim Open the ORCID record for Mohd Afiq Mohd Slim [Opens in a new window]  and
Georgios Kontorinis
Faizan Shah
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Leanne O W Hamilton
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Constantina P Yiannakis
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Mohd Afiq Mohd Slim*
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
Georgios Kontorinis
Affiliation:
ENT Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Corresponding author: Mohd Afiq Mohd Slim; Email: chain1993@yahoo.com
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Abstract

Background

Stereotactic radiosurgery has been shown to be an effective method of managing vestibular schwannomas. The primary aim here is to establish the impact of pre-treatment fast-growing vestibular schwannomas on the efficacy of stereotactic radiosurgery.

Methods

PubMed, Medline and Embase databases were used. The ROBINS-I (‘Risk Of Bias In Non-randomised Studies - of Interventions’) tool was utilised to assess for risk of bias. Proportionate meta-analysis and sub-analysis for fast-growing tumours were performed to explore the success rate of stereotactic radiosurgery in stabilising or decreasing the tumour burden in vestibular schwannomas.

Results

Four moderate risk studies were included in the analysis. Overall, 91 per cent (95 per cent confidence interval = 0.83–0.97, p < 0.01, I2 = 80 per cent) of the tumours demonstrated successful size reduction or stabilisation following stereotactic radiosurgery. Nevertheless, the efficacy of stereotactic radiosurgery in reducing or stabilising fast-growing vestibular schwannomas decreased by 79 per cent (95 per cent confidence interval = 0.64–0.91, p = 0.11, I2 = 62 per cent).

Conclusion

Stereotactic radiosurgery has a statistically significant success rate in stabilising or decreasing the vestibular schwannoma size. This success rate is diminished in fast-growing vestibular schwannomas.

Keywords

Vestibular schwannomaacoustic neuromastereotactic radiosurgery

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1193 - 1199
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mohd Afiq Mohd Slim takes responsibility for the integrity of the content of the paper

Presented at the North American Skull Base Society 31st Annual Meeting, 16–17 February 2022, Phoenix, Arizona, USA.

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