Evidence map›Paper›PMID 39073686›Full record

ArticleJournal of neuro-oncology2024

Repeat stereotactic radiosurgery for progressive vestibular schwannomas after primary gamma knife radiosurgery.

Suchet Taori, Othman Bin-Alamer, Anthony Tang, Ajay Niranjan, John C Flickinger, Constantinos G Hadjipanayis, L Dade Lunsford

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. 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
  3. Review
  4. Review
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

7 authors.

Suchet TaoriSchool of Medicine, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.
Othman Bin-AlamerDepartment of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pennsylvania, PA, 15213, USA. oabinalamer@gmail.com.
Anthony TangSchool of Medicine, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.
Ajay NiranjanSchool of Medicine, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.
John C FlickingerDepartment of Radiation Oncology, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.
Constantinos G HadjipanayisSchool of Medicine, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.
L Dade LunsfordSchool of Medicine, University of Pittsburgh Medical Center, Pennsylvania, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLimited data provides guidance on the management of vestibular schwannomas (VSs) that have progressed despite primary Gamma Knife radiosurgery (GKRS). The present article reports our long-term experience after repeat GKRS for VS with sustained progression after solely primary GKRS management.

methodsA retrospective review of 1997 patients managed between 1987 and 2023 was conducted. Eighteen patients had sustained tumor progression after primary GKRS and 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 in 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).

resultsThe median follow-up was 70 months (IQR: 23-101). After repeat GKRS, two patients had further tumor progression at 4 and 21 months and required partial resection of their tumors. 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. Two patients with serviceable hearing preservation (Gardner-Robertson grade 1 or 2) at repeat GKRS retained that function afterwards. In patients with tinnitus, vestibular dysfunction, and trigeminal neuropathy, symptoms remained stable or improved for 16/16 patients, 12/15 patients, and 10/12 patients, respectively. One patient developed facial twitching in the absence of tumor growth 21 months after repeat GKRS.

conclusionsRepeat GKRS effectively controlled tumor growth and preserved cranial nerve outcomes in most patients whose VS had sustained progression after initial primary radiosurgery.

Indexed as

Disease ProgressionNeuroma, AcousticRadiosurgeryAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedReoperationRetrospective StudiesTreatment OutcomeAdverse radiation effectFacial neuropathyHearing preservationStereotactic radiosurgeryTumor controlVestibular schwannoma

Identifiers

PMID39073686
PMCPMC11341587

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LicenceCC BY
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Registered trials

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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.