KEY TAKEAWAYS
- The study aimed to detail long-term results of repeat GKRS for VS with progression after initial GKRS treatment.
- The results showed repeat GKRS controlled tumor growth and preserved cranial nerve function in most VS patients.
Limited data guides the management of brain cancer involving vestibular schwannomas (VSs) that progressed despite primary Gamma Knife radiosurgery (GKRS).
Suchet Taori and the team aimed to present long-term findings on repeat GKRS for VS with sustained progression following primary GKRS treatment.
The study conducted a retrospective review of 1,997 patients managed between 1987 and 2023. Among them, 18 patients with sustained tumor progression after primary GKRS underwent repeat GKRS. The median repeat GKRS margin dose was 11 Gy (IQR: 11–12), the median tumor volume was 2.0 cc (IQR: 1.3–6.3), and the median cochlear dose for patients with preserved hearing was 3.9 Gy (IQR: 3–4.1). The median time between initial and repeat GKRS was 65 months (IQR: 38–118).
The median follow-up was 70 months (IQR: 23–101). After repeat GKRS, 2 patients experienced further tumor progression at 4 and 21 months, necessitating partial tumor resection. The 10-year actuarial tumor control rate after repeat GKRS was 88%. Facial nerve function was preserved in 13 patients who had House-Brackmann grade 1 or 2 function at the time of repeat GKRS.
About 2 patients with serviceable hearing preservation (Gardner-Robertson grade 1 or 2) at repeat GKRS maintained that function. Symptoms of tinnitus, vestibular dysfunction, and trigeminal neuropathy remained stable or improved in 16/16, 12/15, and 10/12 patients, respectively and 1 patient developed facial twitching without tumor growth 21 months after repeat GKRS.
The study concluded that repeat GKRS effectively controlled tumor growth and preserved cranial nerve outcomes in most patients whose VS had progressed after initial primary radiosurgery.
Open access funding provided by SCELC, Statewide California Electronic Library Consortium.
Source: https://link.springer.com/article/10.1007/s11060-024-04761-9
Taori S, Bin-Alamer O, Tang A, et al. (2024). “Repeat stereotactic radiosurgery for progressive vestibular schwannomas after primary gamma knife radiosurgery.” J Neurooncol. 2024. DOI: https://doi.org/10.1007/s11060-024-04761-9
