Evidence map›Paper›PMID 34777833›Full record

ReviewNeuro-oncology practice2021

Assessing the long-term safety and efficacy of gamma knife and linear accelerator radiosurgery for vestibular schwannoma: A systematic review and meta-analysis.

Sergio W Guadix, Alice J Tao, Anjile An, Michelle Demetres, Umberto Tosi, Swathi Chidambaram, Jonathan P S Knisely, Rohan Ramakrishna, Susan C Pannullo

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neuro-oncology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
1.7field-weighted citation impact, top 16% of its field
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

6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Failure of gamma knife radiosurgery for sporadic vestibular schwannomas: a systematic review and meta-analysis.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 · 2025
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Article
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

9 authors at 1 institution in 1 country.

Sergio W GuadixWeill Cornell Medical College, New York, New York, USA.
Alice J TaoWeill Cornell Medical College, New York, New York, USA.
Anjile AnDivision of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA.
Michelle DemetresSamuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA.ORCID https://orcid.org/0000-0002-4997-7707
Umberto TosiDepartment of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.ORCID https://orcid.org/0000-0003-0847-2400
Swathi ChidambaramDepartment of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
Jonathan P S KniselyDepartment of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA.
Rohan RamakrishnaDepartment of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
Susan C PannulloDepartment of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.ORCID https://orcid.org/0000-0001-6947-1837
Cornell University · US

Funding

Disparities in COVID Disease Severity and Outcomes in New York CityUL1TR002384 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI JULIANNE L IMPERATO-MCGINLEY · 2017 to 2026
$86.2M
NCATS NIH HHS UL1 TR002384
6 · The paper itself

Abstract

backgroundDifferences in long-term outcomes of single-fraction stereotactic radiosurgery (SRS) between gamma knife (GK) and linear accelerator (LINAC) systems for vestibular schwannoma (VS) management remain unclear. To investigate differences in safety and efficacy between modalities, we conducted a meta-analysis of studies over the past decade.

methodsMEDLINE, EMBASE, and Cochrane databases were queried for studies with the following inclusion criteria: English language, published between January 2010 and April 2020, cohort size ≥30, and mean/median follow-up ≥5 years. Odds ratios (OR) compared rates of tumor control, hearing preservation, and cranial nerve toxicities before and after SRS.

resultsThirty-nine studies were included (29 GK, 10 LINAC) with 6516 total patients. Tumor control rates were 93% (95% CI 91-94%) and 94% (95% CI 91-97%) for GK and LINAC, respectively. Both GK (OR 0.06, 95% CI 0.02-0.13) and LINAC (OR 0.47, 95% CI 0.29-0.76) reduced odds of serviceable hearing. Neither GK (OR 0.71, 95% CI 0.41-1.22) nor LINAC (OR 1.13, 95% CI 0.64-2.00) impacted facial nerve function. GK decreased odds of trigeminal nerve (TN) impairment (OR 0.55, 95% CI 0.32-0.94) while LINAC did not impact TN function (OR 1.45, 95% CI 0.81-2.61). Lastly, LINAC offered decreased odds of tinnitus (OR 0.15, 95% CI 0.03-0.87) not observed with GK (OR 0.70, 95% CI 0.48-1.01).

conclusionsVS tumor control and hearing preservation rates are comparable between GK and LINAC SRS. GK may better preserve TN function, while LINAC decreases tinnitus rates. Future studies are warranted to investigate the efficacy of GK and LINAC SRS more directly.

Indexed as

acoustic neuromagamma knifelinear acceleratorradiosurgeryvestibular schwannoma

Identifiers

PMID34777833
PMCPMC8579095
OpenAlexW3207301871

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.