Evidence map›Paper›PMID 41630889›Full record

ReviewNeurosurgery practice2026

CyberKnife Stereotactic Radiosurgery for Vestibular Schwannomas: Systematic Review and Meta-Analysis of Long-Term Tumor Control and Hearing Preservation Outcomes.

Nolan J Brown, Zach Pennington, Saarang Patel, Clifford Jiajun He, Brian V Lien, Redi Rahmani, Julian Gendreau, Joshua S Catapano, Shawn M Stevens, Michael T Lawton

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurosurgery practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

10 authors.

Nolan J BrownDepartment of Neurosurgery, University of California, San Diego, San Diego, California, USA.
Zach PenningtonDepartment of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Saarang PatelDepartment of Neurosurgery, University of California, San Diego, San Diego, California, USA.
Clifford Jiajun HeDepartment of Neurosurgery, University of California, San Diego, San Diego, California, USA.
Brian V LienDepartment of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Redi RahmaniDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Julian GendreauDepartment of Neurosurgery, University of California, San Diego, San Diego, California, USA.
Joshua S CatapanoDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Shawn M StevensOtolaryngology and Lateral Skull Base Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Michael T LawtonDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.ORCID https://orcid.org/0000-0002-1887-3980

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesStereotactic radiosurgery is a popular intervention for small vestibular schwannomas in patients with preserved hearing. Gamma Knife radiosurgery (GKRS) and CyberKnife radiosurgery (CKRS) represent 2 alternative modalities, with CKRS potentially allowing for the delivery of higher doses over multiple sessions. However, the optimal dosing and hearing outcomes of CKRS remain unclear. This study systematically reviewed all literature describing outcomes following treatment of vestibular schwannomas with CKRS, with a focus on tumor control, hearing preservation, and dosing schema.

methodsThe PubMed, Scopus, and Embase databases were queried to identify primary retrospective studies reporting local tumor control and hearing preservation rates following CKRS for vestibular schwannoma. Studies were reviewed, and the systematic review and meta-analysis were performed according to PRISMA and meta-analysis guidelines.

resultsFifteen studies with study periods ranging from 1998 to 2018 were included. These studies comprised 2018 patients (mean age, 60.2 years; range, 11-91 years; 52% female), of whom 64 had neurofibromatosis type 2. The mean follow-up was 40 (range, 6-120) months, and 309 patients had undergone prior treatment (surgery and/or stereotactic radiosurgery). In aggregate, local control at the last follow-up was 96% (95% CI, 95%-98%), and 73% (95% CI, 66%-81%) of patients had preserved hearing. The most common major complications after CKRS were facial neuropathy (1.4%), trigeminal neuralgia (1.3%), and hydrocephalus (0.5%). CKRS provides a high rate of short-term and mid-term tumor control with hearing preservation comparable with GKRS, but long-term outcomes remain under investigated.

conclusionThis systematic review and meta-analysis found that CKRS offers high rates of tumor control and hearing preservation in patients undergoing stereotactic radiosurgery for vestibular schwannomas. Current data suggest that CKRS is a reasonable, safe therapeutic option for patients with small tumors and preserved hearing. Further exploration in larger cohorts and direct comparison with GKRS is merited.

Indexed as

Acoustic neuromaCyberKnifeHearing preservationNeurosurgeryStereotactic radiosurgeryVestibular schwannoma

Identifiers

PMID41630889
PMCPMC12858218

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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.