Evidence map›Paper›PMID 31552587›Full record

ArticleJournal of neuro-oncology2019

Increased cochlear radiation dose predicts delayed hearing loss following both stereotactic radiosurgery and fractionated stereotactic radiotherapy for vestibular schwannoma.

Kunal S Patel, Edwin Ng, Taranjit Kaur, Tyler Miao, Tania Kaprealian, Percy Lee, Nader Pouratian, Michael T Selch, Antonio A F De Salles, Quinton Gopen and 2 more

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In one paragraph

Article in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Article
  4. Comprehensive Genetic Analysis ofLaryngoscope investigative otolaryngology · 2025
    Article
  5. Long-term hearing prognosis after vestibular schwannoma surgery with retrolabyrinthine approach.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kunal S PatelDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, USA.
Edwin NgDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, USA.
Taranjit KaurDepartment of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Tyler MiaoDepartment of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Tania KaprealianDepartment of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
Percy LeeDepartment of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
Nader PouratianDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, USA.
Michael T SelchDepartment of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
Antonio A F De SallesDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, USA.
Quinton GopenDepartment of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Stephen TennDepartment of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
Isaac YangDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, USA. Iyang@mednet.ucla.edu.ORCID http://orcid.org/0000-0002-5176-5615

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) are noninvasive therapies for vestibular schwannomas providing excellent tumor control. However, delayed hearing loss after radiation therapy remains an issue. One potential target to for improving hearing rates is limiting radiation exposure to the cochlea.

methodsWe retrospectively reviewed 100 patients undergoing either SRS with 12 Gy (n = 43) or fSRT with 50 Gy over 28 fractions (n = 57) for vestibular schwannoma. Univariate and multivariate analysis were carried out to identify predictors of hearing loss as measured by the Gardner Robertson scale after radiation therapy.

resultsDeterioration of hearing occurred in 30% of patients with SRS and 26% with fSRT. The overall long term (> 2 year) progression rates were 20% for SRS and 16% for fSRT. Patients with a decrease in their Gardner Robertson hearing score and those that loss serviceable hearing had significantly higher average minimal doses to the cochlea in both SRS and fSRT cohorts. ROC analysis showed that a cut off of 5 Gy and 35 Gy, for SRS and fSRT respectively, predicted hearing loss with high sensitivity/specificity.

conclusionOur data suggests the minimal dose of radiation that the cochlear volume is exposed to is a predictor of delayed hearing loss after either SRS or fSRT. A threshold of 5 Gy/35 Gy may lead to improved hearing preservation after radiotherapy. Further prospective multi center studies can further elucidate this mechanism.

Indexed as

Dose Fractionation, RadiationAdolescentAdultAgedAged, 80 and overCochleaFemaleHearing Loss, SensorineuralHearing TestsHumansMaleMiddle AgedNeuroma, AcousticRadiosurgeryROC CurveYoung AdultCochleaFractionated radiotherapyServiceable hearingStereotactic radiosurgeryVestibular schwannoma

Identifiers

PMID31552587

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.