A retrospective cohort study of stereotactic radiosurgery for vestibular schwannomas: Comparison of two age groups (75 years or older vs. 65–74 years)

Author:

Watanabe Shinya12,Yamamoto Masaaki3,Aiyama Hitoshi4,Sugii Narushi5,Matsuda Masahide6,Akutsu Hiroyoshi7,Ishikawa Eiichi6

Affiliation:

1. Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan

2. Department of Neurosurgery, Mito Kyodo General Hospital, Tsukuba University Hospital, Mito Area Medical Education Center, Mito, Ibaraki, Japan

3. Department of Neurosurgery, Southern Tohoku Hospital, Koriyama, Japan

4. Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan

5. Department of Neurosurgery, University of Tsukuba Hospital, Tsukuba, Japan

6. Department of Neurosurgery, University of Tsukuba, Tsukuba, Japan

7. Department of Neurosurgery, Dokkyo Medical University, Mibu, Japan

Abstract

Background: Treatment outcome data of stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) in patients ≥75 years (late elderly) are lacking. Approximately 39% of patients ≥75 years with VS were reported to experience severe facial palsy after surgical removal. This study compared the treatment outcomes post-SRS for VS between patients ≥75 and 65–74 years (early elderly). Methods: Of 453 patients who underwent gamma knife SRS for VS, 156 were ≥65 years old. The late and early elderly groups comprised 35 and 121 patients, respectively. The median tumor volume was 4.4 cc, and the median radiation dose was 12.0 Gy. Results: The median follow-up periods were 37 and 56 months in the late and early elderly groups, respectively. Tumor volume control was observed in 27 (88%) and 95 (83%) patients (P = 0.78), while additional procedures were required in 2 (6%) and 6 (6%) patients (P = 1.00) in the late and early elderly groups, respectively. At the 60th and 120th months post-SRS, the cumulative tumor control rates were 87%, 75%, 85%, and 73% (P = 0.81), while the cumulative clinical control rates were 93% and 87%, 95%, and 89% (P = 0.80), in the late and early elderly groups, respectively. In the early elderly group, two patients experienced facial pain, and one experienced facial palsy post-SRS; there were no adverse effects in the late elderly group (both P = 1.00). Conclusion: SRS is effective for VS and beneficial in patients ≥75 years old as it preserves the facial nerve.

Publisher

Scientific Scholar

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