SynthesisJournal of neuro-oncology2023
Single-fraction radiosurgery outcomes for large vestibular schwannomas in the upfront or post-surgical setting: a systematic review and International Stereotactic Radiosurgery Society (ISRS) Practice Guidelines.
Synthesis in Journal of neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
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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.
The trial behind it
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- A systematic evaluation of clinical practice guidelines for the treatment and management of vestibular schwannoma.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 · 2025Pooled it
- Large vestibular schwannoma treated using a cranial nerve sparing approach with planned subtotal microsurgical resection and stereotactic radiosurgery: meta-analysis and International Stereotactic Radiosurgery Society (ISRS) practice guidelines.Journal of neuro-oncology · 2025Pooled it
- Stereotactic radiosurgery for Koos grade IV vestibular schwannoma: a systematic review and meta-analysis.Acta neurochirurgica · 2024Pooled it
- Radiotherapy for Vestibular Schwannoma: Retrospective Cohort and Propensity Score Matching Analysis.Journal of neurological surgery. Part B, Skull base · 2026Article
- Pseudoprogression in Koos grade 4 vestibular schwannomas following stereotactic radiosurgery: temporal dynamics and radiological predictors.Journal of neuro-oncology · 2026Article
- The evolution of stereotactic radiosurgery for vestibular schwannomas: recent evidence and outcomes.Journal of neuro-oncology · 2025Review
- Radiotherapy for Growing Vestibular Schwannomas.JAMA otolaryngology-- head & neck surgery · 2025Article
- Management of treatment-naïve Koos grade IV vestibular schwannomas using hypofractionated Gamma Knife radiosurgery: a retrospective single-institution study.Neurosurgical review · 2024Article
- Controversies in neuro-oncology: Focal proton versus photon radiation therapy for adult brain tumors.Neuro-oncology practice · 2024Review
- Spontaneous Regression of a Large Vestibular Schwannoma: Is Nonoperative Management Reasonable?Brain tumor research and treatment · 2024Article
- Stereotactic radiosurgery for large vestibular schwannomas: 2.5 cm and beyond.Journal of neuro-oncology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo perform a systematic review of literature specific to single-fraction stereotactic radiosurgery (SRS) for large vestibular schwannomas (VS), maximum diameter ≥ 2.5 cm and/or classified as Koos Grade IV, and to present consensus recommendations on behalf of the International Stereotactic Radiosurgery Society (ISRS).
methodsThe Medline and Embase databases were used to apply the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. We considered eligible prospective and retrospective studies, written in the English language, reporting treatment outcomes for large VS; SRS for large post-operative tumors were analyzed in aggregate and separately.
results19 of the 229 studies initially identified met the final inclusion criteria. Overall crude rate of tumor control was 89% (93.7% with no prior surgery vs 87.7% with prior surgery). Rates of salvage microsurgical resection, need for shunt, and additional SRS in all series versus those with no prior surgery were 9.6% vs 3.3%, 4.7% vs 6.4% and 1% vs 0.9%, respectively. Rates of facial palsy and hearing preservation in all series versus those with no prior surgery were 1.3% vs 3.4% and 34.2% vs 40.4%, respectively.
conclusionsUpfront SRS resulted in high rates of tumor control with acceptable rates of facial palsy and hearing preservation as compared to the results in those series including patients with prior surgery (level C evidence). Therefore, although large VS are considered classic indication for microsurgical resection, upfront SRS can be considered in selected patients and we recommend a prescribed marginal dose from 11 to 13 Gy (level C evidence).
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Registered trials
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.