3D quantitative assessment of response to fractionated stereotactic radiotherapy and single-session stereotactic radiosurgery of vestibular schwannoma

作者：Schneider T^*; Chapiro J; Lin M; Geschwind J F; Kleinberg L; Rigamonti D; Jusue Torres I; Marciscano A E; Yousem D M

来源：European Radiology, 2016, 26(3): 849-857.

DOI：10.1007/s00330-015-3895-9

• Magnetic resonance imaging
• Vestibular schwannoma
• Radiotherapy
• Gamma Knife radiosurgery
• Benign neoplasms

To determine clinical outcome of patients with vestibular schwannoma (VS) after treatment with fractionated stereotactic radiotherapy (FSRT) and single-session stereotactic radiosurgery (SRS) by using 3D quantitative response assessment on MRI.
This retrospective analysis included 162 patients who underwent radiation therapy for sporadic VS. Measurements on T1-weighted contrast-enhanced MRI (in 2-year post-therapy intervals: 0-2, 2-4, 4-6, 6-8, 8-10, 10-12 years) were taken for total tumour volume (TTV) and enhancing tumour volume (ETV) based on a semi-automated technique. Patients were considered non-responders (NRs) if they required subsequent microsurgical resection or developed radiological progression and tumour-related symptoms.
Median follow-up was 4.1 years (range: 0.4-12.0). TTV and ETV decreased for both the FSRT and SRS groups. However, only the FSRT group achieved significant tumour shrinkage (p < 0.015 for TTV, p < 0.005 for ETV over time). The 11 NRs showed proportionally greater TTV (median TTV pre-treatment: 0.61 cm(3), 8-10 years after: 1.77 cm(3)) and ETV despite radiation therapy compared to responders (median TTV pre-treatment: 1.06 cm(3); 10-12 years after: 0.81 cm(3); p = 0.001).
3D quantification of VS showed a significant decrease in TTV and ETV on FSRT-treated patients only. NR had significantly greater TTV and ETV over time.
aEuro cent Only FSRT not GK-treated patients showed significant tumour shrinkage over time.
aEuro cent Clinical non-responders showed significantly less tumour shrinkage when compared to responders.
aEuro cent 3D volumetric assessment of vestibular schwannoma shows advantages over unidimensional techniques.

• 出版日期2016-3