Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma

P.P.J.H. Langenhuizen, Sveta Zinger, Sieger Leenstra, P. Hanssens, Peter de With, H.B. Verheul

Research output: Contribution to conferenceAbstractAcademic

Abstract

Introduction
Gamma Knife radiosurgery (GKRS) is an effective treatment strategy for vestibular schwannomas (VSs), obtaining long-term tumor control rates of 90%. Currently, predicting long-term tumor control is not possible, making lifelong follow-up mandatory and prospective studies on tumor control difficult to conduct. Therefore, predicting tumor control at earlier stages would be beneficial. We explored the predictability of long-term tumor control employing short-term volumetric tumor responses.

Methods
All VS patients with minimum follow-up of 3 years were included. Tumor volumes were obtained from follow-up MRIs. Tumor volume reduction (TVR) was calculated at 6, 12, 24 and 36 months following GKRS. Correlations between TVRs and long-term tumor control were evaluated.

Results
We included 795 patients, of which 96 showed loss of tumor control. The median follow-up time was 61 months. TVRs at 6, 12, 24, and 36 months were based on MRIs from 186, 693, 541 and 399 patients, respectively. Cox regression analyses indicate that TVRs at 6, 24 and 36 months are significantly related to tumor control, indicating a proportional correlation. Kaplan-Meier analyses, when stratifying the cohort in 4 groups based on the TVRs, confirmed this relation: tumors with pronounced TVRs in the first years following GKRS had significantly lower risks of treatment failure, as compared to increasing tumors. For example, if tumor volumes were stable or decreasing between 6 and 24 months after GKRS, loss of long-term tumor control was observed rarely compared to tumors with increasing volumes in this follow-up period: 10-year tumor control probabilities are 92.0% and 67.1%, respectively.

Conclusions
Results from this research clearly indicate that TVRs at 6, 24 and 36 months following treatment are predictive for long-term tumor control in GKRS-treated VS. These findings can help in determining an individual follow-up schedule for VS patients and make prospective studies on long-term tumor control more feasible.
Original languageEnglish
Publication statusPublished - Jun 2019
Event14th International Stereotactic Radiosurgery Society Congress - Windsor Expo Convention Center (WECC), Rio de Janeiro, Brazil
Duration: 9 Jun 201913 Jun 2019
https://2019.isrscongress.org/en/

Conference

Conference14th International Stereotactic Radiosurgery Society Congress
Abbreviated titleISRS2019
CountryBrazil
CityRio de Janeiro
Period9/06/1913/06/19
Internet address

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Acoustic Neuroma
Radiosurgery
Neoplasms
Tumor Burden
Prospective Studies
Kaplan-Meier Estimate
Treatment Failure

Keywords

  • volumetric response
  • vestibular schwannoma
  • gamma knife radiosurgery

Cite this

Langenhuizen, P. P. J. H., Zinger, S., Leenstra, S., Hanssens, P., de With, P., & Verheul, H. B. (2019). Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.
Langenhuizen, P.P.J.H. ; Zinger, Sveta ; Leenstra, Sieger ; Hanssens, P. ; de With, Peter ; Verheul, H.B. / Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.
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title = "Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma",
abstract = "IntroductionGamma Knife radiosurgery (GKRS) is an effective treatment strategy for vestibular schwannomas (VSs), obtaining long-term tumor control rates of 90{\%}. Currently, predicting long-term tumor control is not possible, making lifelong follow-up mandatory and prospective studies on tumor control difficult to conduct. Therefore, predicting tumor control at earlier stages would be beneficial. We explored the predictability of long-term tumor control employing short-term volumetric tumor responses. MethodsAll VS patients with minimum follow-up of 3 years were included. Tumor volumes were obtained from follow-up MRIs. Tumor volume reduction (TVR) was calculated at 6, 12, 24 and 36 months following GKRS. Correlations between TVRs and long-term tumor control were evaluated.ResultsWe included 795 patients, of which 96 showed loss of tumor control. The median follow-up time was 61 months. TVRs at 6, 12, 24, and 36 months were based on MRIs from 186, 693, 541 and 399 patients, respectively. Cox regression analyses indicate that TVRs at 6, 24 and 36 months are significantly related to tumor control, indicating a proportional correlation. Kaplan-Meier analyses, when stratifying the cohort in 4 groups based on the TVRs, confirmed this relation: tumors with pronounced TVRs in the first years following GKRS had significantly lower risks of treatment failure, as compared to increasing tumors. For example, if tumor volumes were stable or decreasing between 6 and 24 months after GKRS, loss of long-term tumor control was observed rarely compared to tumors with increasing volumes in this follow-up period: 10-year tumor control probabilities are 92.0{\%} and 67.1{\%}, respectively.ConclusionsResults from this research clearly indicate that TVRs at 6, 24 and 36 months following treatment are predictive for long-term tumor control in GKRS-treated VS. These findings can help in determining an individual follow-up schedule for VS patients and make prospective studies on long-term tumor control more feasible.",
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year = "2019",
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Langenhuizen, PPJH, Zinger, S, Leenstra, S, Hanssens, P, de With, P & Verheul, HB 2019, 'Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma' 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil, 9/06/19 - 13/06/19, .

Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma. / Langenhuizen, P.P.J.H.; Zinger, Sveta; Leenstra, Sieger; Hanssens, P.; de With, Peter; Verheul, H.B.

2019. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.

Research output: Contribution to conferenceAbstractAcademic

TY - CONF

T1 - Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma

AU - Langenhuizen, P.P.J.H.

AU - Zinger, Sveta

AU - Leenstra, Sieger

AU - Hanssens, P.

AU - de With, Peter

AU - Verheul, H.B.

PY - 2019/6

Y1 - 2019/6

N2 - IntroductionGamma Knife radiosurgery (GKRS) is an effective treatment strategy for vestibular schwannomas (VSs), obtaining long-term tumor control rates of 90%. Currently, predicting long-term tumor control is not possible, making lifelong follow-up mandatory and prospective studies on tumor control difficult to conduct. Therefore, predicting tumor control at earlier stages would be beneficial. We explored the predictability of long-term tumor control employing short-term volumetric tumor responses. MethodsAll VS patients with minimum follow-up of 3 years were included. Tumor volumes were obtained from follow-up MRIs. Tumor volume reduction (TVR) was calculated at 6, 12, 24 and 36 months following GKRS. Correlations between TVRs and long-term tumor control were evaluated.ResultsWe included 795 patients, of which 96 showed loss of tumor control. The median follow-up time was 61 months. TVRs at 6, 12, 24, and 36 months were based on MRIs from 186, 693, 541 and 399 patients, respectively. Cox regression analyses indicate that TVRs at 6, 24 and 36 months are significantly related to tumor control, indicating a proportional correlation. Kaplan-Meier analyses, when stratifying the cohort in 4 groups based on the TVRs, confirmed this relation: tumors with pronounced TVRs in the first years following GKRS had significantly lower risks of treatment failure, as compared to increasing tumors. For example, if tumor volumes were stable or decreasing between 6 and 24 months after GKRS, loss of long-term tumor control was observed rarely compared to tumors with increasing volumes in this follow-up period: 10-year tumor control probabilities are 92.0% and 67.1%, respectively.ConclusionsResults from this research clearly indicate that TVRs at 6, 24 and 36 months following treatment are predictive for long-term tumor control in GKRS-treated VS. These findings can help in determining an individual follow-up schedule for VS patients and make prospective studies on long-term tumor control more feasible.

AB - IntroductionGamma Knife radiosurgery (GKRS) is an effective treatment strategy for vestibular schwannomas (VSs), obtaining long-term tumor control rates of 90%. Currently, predicting long-term tumor control is not possible, making lifelong follow-up mandatory and prospective studies on tumor control difficult to conduct. Therefore, predicting tumor control at earlier stages would be beneficial. We explored the predictability of long-term tumor control employing short-term volumetric tumor responses. MethodsAll VS patients with minimum follow-up of 3 years were included. Tumor volumes were obtained from follow-up MRIs. Tumor volume reduction (TVR) was calculated at 6, 12, 24 and 36 months following GKRS. Correlations between TVRs and long-term tumor control were evaluated.ResultsWe included 795 patients, of which 96 showed loss of tumor control. The median follow-up time was 61 months. TVRs at 6, 12, 24, and 36 months were based on MRIs from 186, 693, 541 and 399 patients, respectively. Cox regression analyses indicate that TVRs at 6, 24 and 36 months are significantly related to tumor control, indicating a proportional correlation. Kaplan-Meier analyses, when stratifying the cohort in 4 groups based on the TVRs, confirmed this relation: tumors with pronounced TVRs in the first years following GKRS had significantly lower risks of treatment failure, as compared to increasing tumors. For example, if tumor volumes were stable or decreasing between 6 and 24 months after GKRS, loss of long-term tumor control was observed rarely compared to tumors with increasing volumes in this follow-up period: 10-year tumor control probabilities are 92.0% and 67.1%, respectively.ConclusionsResults from this research clearly indicate that TVRs at 6, 24 and 36 months following treatment are predictive for long-term tumor control in GKRS-treated VS. These findings can help in determining an individual follow-up schedule for VS patients and make prospective studies on long-term tumor control more feasible.

KW - volumetric response

KW - vestibular schwannoma

KW - gamma knife radiosurgery

M3 - Abstract

ER -

Langenhuizen PPJH, Zinger S, Leenstra S, Hanssens P, de With P, Verheul HB. Short-term volumetric tumor response as predictor for long-term tumor control after Gamma Knife radiosurgery of vestibular schwannoma. 2019. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.