Gamma Knife radiosurgery following partial resection of large vestibular schwannomas: evaluation of long-term tumor control

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

Onderzoeksoutput: Bijdrage aan congresAbstractAcademic

Uittreksel

IntroductionRecently, we have reported the influence of pretreatment growth rates on Gamma Knife radiosurgery (GKRS) of vestibular schwannomas (VS): fast growing tumors are less likely to obtain tumor control.1 This indicates that biological aspects intrinsic to VS are influencing the GKRS treatment outcome. Also, various papers have reported that GKRS treatment for large VS is significantly less effective compared to small-to-medium-sized VS. These findings suggest that large VS may have biological properties similar to those of fast-growing VS. To evaluate this, we assessed the long-term GKRS tumor control of remnants of large VS after partial resection. Furthermore, we compared this to the outcome of large tumors (>10cc) that were not resected, but received primary GKRS. MethodsPatients with a minimum follow-up of 4 years were included. Loss of tumor control was defined as radiological progression. All patients were uniformly treated according to protocol. We employed Kaplan-Meier survival analyses to determine differences in tumor control probability rates following GKRS between small-to-medium-sized VS and large VS, either after partial resection or after primary GKRS treatment.ResultsIn our center, 736 patients received primary GKRS treatment, while 77 patients were first subjected to partial resection. Kaplan-Meier analyses showed significantly lower tumor control rates for large tumors, both after partial resection and after primary treatment, compared to the small-to-medium-sized VS (log-rank, p<0.001). The obtained 10-year tumor control rates were 78.5%, 73.6%, and 89.7%, respectively. These control rates observed in large VS are even worse than the rates observed in fast growing small-to-medium-sized tumors (85.1%).1ConclusionsResults from this research clearly show that tumor control rates of large VS, either after partial resection or primary treatment, show lower tumor control rates following GKRS. The survival curves of these tumors resemble the curve of extremely fast growing VS, suggesting that the intrinsic tumor biology is indeed an important factor influencing tumor control rates of VS after GKRS.References1. Langenhuizen PPJH, Zinger S, Hanssens PEJ, Kunst HPM, Mulder JJS, Leenstra S, et al. (2018). Influence of pretreatment growth rate on Gamma Knife treatment response for vestibular schwannoma: a volumetric analysis. J Neurosurg, ,1-8.

Congres

Congres14th International Stereotactic Radiosurgery Society Congress
Verkorte titelISRS2019
LandBrazilië
StadRio de Janeiro
Periode9/06/1913/06/19
Internet adres

Vingerafdruk

Acoustic Neuroma
Radiosurgery
Neoplasms
Kaplan-Meier Estimate
Therapeutics
Survival Analysis
Growth

Trefwoorden

    Citeer dit

    Langenhuizen, P. P. J. H., Fu, V., Zinger, S., Leenstra, S., Hanssens, P., de With, P., & Verheul, H. B. (2019). Gamma Knife radiosurgery following partial resection of large vestibular schwannomas: evaluation of long-term tumor control. Abstract van 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazilië.
    Langenhuizen, P.P.J.H. ; Fu, V. ; Zinger, Sveta ; Leenstra, Sieger ; Hanssens, P. ; de With, Peter ; Verheul, H.B./ Gamma Knife radiosurgery following partial resection of large vestibular schwannomas : evaluation of long-term tumor control. Abstract van 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazilië.
    @conference{6523d9a754cb4a8f99f3afad32bdb33c,
    title = "Gamma Knife radiosurgery following partial resection of large vestibular schwannomas: evaluation of long-term tumor control",
    abstract = "IntroductionRecently, we have reported the influence of pretreatment growth rates on Gamma Knife radiosurgery (GKRS) of vestibular schwannomas (VS): fast growing tumors are less likely to obtain tumor control.1 This indicates that biological aspects intrinsic to VS are influencing the GKRS treatment outcome. Also, various papers have reported that GKRS treatment for large VS is significantly less effective compared to small-to-medium-sized VS. These findings suggest that large VS may have biological properties similar to those of fast-growing VS. To evaluate this, we assessed the long-term GKRS tumor control of remnants of large VS after partial resection. Furthermore, we compared this to the outcome of large tumors (>10cc) that were not resected, but received primary GKRS. MethodsPatients with a minimum follow-up of 4 years were included. Loss of tumor control was defined as radiological progression. All patients were uniformly treated according to protocol. We employed Kaplan-Meier survival analyses to determine differences in tumor control probability rates following GKRS between small-to-medium-sized VS and large VS, either after partial resection or after primary GKRS treatment.ResultsIn our center, 736 patients received primary GKRS treatment, while 77 patients were first subjected to partial resection. Kaplan-Meier analyses showed significantly lower tumor control rates for large tumors, both after partial resection and after primary treatment, compared to the small-to-medium-sized VS (log-rank, p<0.001). The obtained 10-year tumor control rates were 78.5{\%}, 73.6{\%}, and 89.7{\%}, respectively. These control rates observed in large VS are even worse than the rates observed in fast growing small-to-medium-sized tumors (85.1{\%}).1ConclusionsResults from this research clearly show that tumor control rates of large VS, either after partial resection or primary treatment, show lower tumor control rates following GKRS. The survival curves of these tumors resemble the curve of extremely fast growing VS, suggesting that the intrinsic tumor biology is indeed an important factor influencing tumor control rates of VS after GKRS.References1. Langenhuizen PPJH, Zinger S, Hanssens PEJ, Kunst HPM, Mulder JJS, Leenstra S, et al. (2018). Influence of pretreatment growth rate on Gamma Knife treatment response for vestibular schwannoma: a volumetric analysis. J Neurosurg, ,1-8.",
    keywords = "partial resection, vestibular schwannoma, gamma knife radiosurgery",
    author = "P.P.J.H. Langenhuizen and V. Fu and Sveta Zinger and Sieger Leenstra and P. Hanssens and {de With}, Peter and H.B. Verheul",
    year = "2019",
    month = "6",
    language = "English",
    note = "14th International Stereotactic Radiosurgery Society Congress, ISRS2019 ; Conference date: 09-06-2019 Through 13-06-2019",
    url = "https://2019.isrscongress.org/en/",

    }

    Gamma Knife radiosurgery following partial resection of large vestibular schwannomas : evaluation of long-term tumor control. / Langenhuizen, P.P.J.H.; Fu, V.; Zinger, Sveta; Leenstra, Sieger; Hanssens, P.; de With, Peter; Verheul, H.B.

    2019. Abstract van 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazilië.

    Onderzoeksoutput: Bijdrage aan congresAbstractAcademic

    TY - CONF

    T1 - Gamma Knife radiosurgery following partial resection of large vestibular schwannomas

    T2 - evaluation of long-term tumor control

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

    AU - Fu,V.

    AU - Zinger,Sveta

    AU - Leenstra,Sieger

    AU - Hanssens,P.

    AU - de With,Peter

    AU - Verheul,H.B.

    PY - 2019/6

    Y1 - 2019/6

    N2 - IntroductionRecently, we have reported the influence of pretreatment growth rates on Gamma Knife radiosurgery (GKRS) of vestibular schwannomas (VS): fast growing tumors are less likely to obtain tumor control.1 This indicates that biological aspects intrinsic to VS are influencing the GKRS treatment outcome. Also, various papers have reported that GKRS treatment for large VS is significantly less effective compared to small-to-medium-sized VS. These findings suggest that large VS may have biological properties similar to those of fast-growing VS. To evaluate this, we assessed the long-term GKRS tumor control of remnants of large VS after partial resection. Furthermore, we compared this to the outcome of large tumors (>10cc) that were not resected, but received primary GKRS. MethodsPatients with a minimum follow-up of 4 years were included. Loss of tumor control was defined as radiological progression. All patients were uniformly treated according to protocol. We employed Kaplan-Meier survival analyses to determine differences in tumor control probability rates following GKRS between small-to-medium-sized VS and large VS, either after partial resection or after primary GKRS treatment.ResultsIn our center, 736 patients received primary GKRS treatment, while 77 patients were first subjected to partial resection. Kaplan-Meier analyses showed significantly lower tumor control rates for large tumors, both after partial resection and after primary treatment, compared to the small-to-medium-sized VS (log-rank, p<0.001). The obtained 10-year tumor control rates were 78.5%, 73.6%, and 89.7%, respectively. These control rates observed in large VS are even worse than the rates observed in fast growing small-to-medium-sized tumors (85.1%).1ConclusionsResults from this research clearly show that tumor control rates of large VS, either after partial resection or primary treatment, show lower tumor control rates following GKRS. The survival curves of these tumors resemble the curve of extremely fast growing VS, suggesting that the intrinsic tumor biology is indeed an important factor influencing tumor control rates of VS after GKRS.References1. Langenhuizen PPJH, Zinger S, Hanssens PEJ, Kunst HPM, Mulder JJS, Leenstra S, et al. (2018). Influence of pretreatment growth rate on Gamma Knife treatment response for vestibular schwannoma: a volumetric analysis. J Neurosurg, ,1-8.

    AB - IntroductionRecently, we have reported the influence of pretreatment growth rates on Gamma Knife radiosurgery (GKRS) of vestibular schwannomas (VS): fast growing tumors are less likely to obtain tumor control.1 This indicates that biological aspects intrinsic to VS are influencing the GKRS treatment outcome. Also, various papers have reported that GKRS treatment for large VS is significantly less effective compared to small-to-medium-sized VS. These findings suggest that large VS may have biological properties similar to those of fast-growing VS. To evaluate this, we assessed the long-term GKRS tumor control of remnants of large VS after partial resection. Furthermore, we compared this to the outcome of large tumors (>10cc) that were not resected, but received primary GKRS. MethodsPatients with a minimum follow-up of 4 years were included. Loss of tumor control was defined as radiological progression. All patients were uniformly treated according to protocol. We employed Kaplan-Meier survival analyses to determine differences in tumor control probability rates following GKRS between small-to-medium-sized VS and large VS, either after partial resection or after primary GKRS treatment.ResultsIn our center, 736 patients received primary GKRS treatment, while 77 patients were first subjected to partial resection. Kaplan-Meier analyses showed significantly lower tumor control rates for large tumors, both after partial resection and after primary treatment, compared to the small-to-medium-sized VS (log-rank, p<0.001). The obtained 10-year tumor control rates were 78.5%, 73.6%, and 89.7%, respectively. These control rates observed in large VS are even worse than the rates observed in fast growing small-to-medium-sized tumors (85.1%).1ConclusionsResults from this research clearly show that tumor control rates of large VS, either after partial resection or primary treatment, show lower tumor control rates following GKRS. The survival curves of these tumors resemble the curve of extremely fast growing VS, suggesting that the intrinsic tumor biology is indeed an important factor influencing tumor control rates of VS after GKRS.References1. Langenhuizen PPJH, Zinger S, Hanssens PEJ, Kunst HPM, Mulder JJS, Leenstra S, et al. (2018). Influence of pretreatment growth rate on Gamma Knife treatment response for vestibular schwannoma: a volumetric analysis. J Neurosurg, ,1-8.

    KW - partial resection

    KW - vestibular schwannoma

    KW - gamma knife radiosurgery

    M3 - Abstract

    ER -

    Langenhuizen PPJH, Fu V, Zinger S, Leenstra S, Hanssens P, de With P et al. Gamma Knife radiosurgery following partial resection of large vestibular schwannomas: evaluation of long-term tumor control. 2019. Abstract van 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazilië.