Treatment options for unilateral vestibular schwannoma: a network meta-analysis

Abstract This study aimed to explore the effect of observation, microsurgery, and radiotherapy for patients with vestibular schwannoma (VS). We searched PubMed, Medline, Embase, Web of Science, and Cochrane library from their establishment to July 31, 2024. 34 non-RCTs and 1 RCT that included 6 inte...

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Main Authors: Xianhao Huo, Xu Zhao, Xiaozhuo Liu, Yifan Zhang, Jihui Tian, Mei Li
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13242-1
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author Xianhao Huo
Xu Zhao
Xiaozhuo Liu
Yifan Zhang
Jihui Tian
Mei Li
author_facet Xianhao Huo
Xu Zhao
Xiaozhuo Liu
Yifan Zhang
Jihui Tian
Mei Li
author_sort Xianhao Huo
collection DOAJ
description Abstract This study aimed to explore the effect of observation, microsurgery, and radiotherapy for patients with vestibular schwannoma (VS). We searched PubMed, Medline, Embase, Web of Science, and Cochrane library from their establishment to July 31, 2024. 34 non-RCTs and 1 RCT that included 6 interventions were analyzed. We found the MS, and different SRS all had better tumor local control rates. Regarding preserved hearing, the order from the highest to the lowest was FSRT 5 fractions, FSRT 3 fractions, SRS, ConFSRT, Observation, and MS. Regarding improvement in the rate of tinnitus, the order from the highest to the lowest was ConFSRT, FSRT 3 fractions, SRS, Observation, MS, and FSRT 5 fractions. In terms of improving the rate of disequilibrium/vertigo, the order from the highest to the lowest was SRS, Observation, FSRT 3 fractions, FSRT 5 fractions, MS, and ConFSRT. In terms of protection of the trigeminal nerve, the order from the highest to lowest was observation, SRS, ConFSRT, FSRT 3 fractions, FSRT 5 fractions, and MS. Lastly, in terms of protection of the facial nerve, the order from the highest to lowest was SRS, ConFSRT, Observation, FSRT 3 fractions, FSRT 5 fractions, and MS. In patients with VS, MS and radiosurgery showed better local tumor control rates; however, compared with MS, different SRS all provided better protection of nerve function and improved the symptoms of vestibular function and tinnitus, among which the best was SRS. Therefore, in these patients, SRS may be a promising alternative treatment.
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spelling doaj-art-3140ceb3a1ee438e80e5ca1eb2037a3c2024-12-08T12:33:35ZengBMCBMC Cancer1471-24072024-12-0124111310.1186/s12885-024-13242-1Treatment options for unilateral vestibular schwannoma: a network meta-analysisXianhao Huo0Xu Zhao1Xiaozhuo Liu2Yifan Zhang3Jihui Tian4Mei Li5Department of Neurosurgery, General Hospital of Ningxia Medical UniversityDepartment of Neurosurgery, North China University of Science and Technology Affiliated HospitalDepartment of Neurosurgery, North China University of Science and Technology Affiliated HospitalDepartment of Neurosurgery, General Hospital of Ningxia Medical UniversityDepartment of Neurosurgery, General Hospital of Ningxia Medical UniversityDepartment of Neurosurgery, The First Medical Center of Chinese PLA General HospitalAbstract This study aimed to explore the effect of observation, microsurgery, and radiotherapy for patients with vestibular schwannoma (VS). We searched PubMed, Medline, Embase, Web of Science, and Cochrane library from their establishment to July 31, 2024. 34 non-RCTs and 1 RCT that included 6 interventions were analyzed. We found the MS, and different SRS all had better tumor local control rates. Regarding preserved hearing, the order from the highest to the lowest was FSRT 5 fractions, FSRT 3 fractions, SRS, ConFSRT, Observation, and MS. Regarding improvement in the rate of tinnitus, the order from the highest to the lowest was ConFSRT, FSRT 3 fractions, SRS, Observation, MS, and FSRT 5 fractions. In terms of improving the rate of disequilibrium/vertigo, the order from the highest to the lowest was SRS, Observation, FSRT 3 fractions, FSRT 5 fractions, MS, and ConFSRT. In terms of protection of the trigeminal nerve, the order from the highest to lowest was observation, SRS, ConFSRT, FSRT 3 fractions, FSRT 5 fractions, and MS. Lastly, in terms of protection of the facial nerve, the order from the highest to lowest was SRS, ConFSRT, Observation, FSRT 3 fractions, FSRT 5 fractions, and MS. In patients with VS, MS and radiosurgery showed better local tumor control rates; however, compared with MS, different SRS all provided better protection of nerve function and improved the symptoms of vestibular function and tinnitus, among which the best was SRS. Therefore, in these patients, SRS may be a promising alternative treatment.https://doi.org/10.1186/s12885-024-13242-1Vestibular schwannomaMicrosurgeryStereotactic radiosurgeryFractionated stereotactic radiotherapyConventionally fractionated stereotactic radiotherapy
spellingShingle Xianhao Huo
Xu Zhao
Xiaozhuo Liu
Yifan Zhang
Jihui Tian
Mei Li
Treatment options for unilateral vestibular schwannoma: a network meta-analysis
BMC Cancer
Vestibular schwannoma
Microsurgery
Stereotactic radiosurgery
Fractionated stereotactic radiotherapy
Conventionally fractionated stereotactic radiotherapy
title Treatment options for unilateral vestibular schwannoma: a network meta-analysis
title_full Treatment options for unilateral vestibular schwannoma: a network meta-analysis
title_fullStr Treatment options for unilateral vestibular schwannoma: a network meta-analysis
title_full_unstemmed Treatment options for unilateral vestibular schwannoma: a network meta-analysis
title_short Treatment options for unilateral vestibular schwannoma: a network meta-analysis
title_sort treatment options for unilateral vestibular schwannoma a network meta analysis
topic Vestibular schwannoma
Microsurgery
Stereotactic radiosurgery
Fractionated stereotactic radiotherapy
Conventionally fractionated stereotactic radiotherapy
url https://doi.org/10.1186/s12885-024-13242-1
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