Abstract：
Management of vestibular schwannoma (VS) is a complex process aimed at identifying a clinical indication for fractionated stereotactic radiotherapy (sRT) or microsurgical resection or wait and scan (WS). The aim of the review was to clarify which patient and tumor parameters may lead to different therapeutic choices, with a view to a personalized VS approach. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between February and March 2022. The authors defined six parameters that seemed to influence decision-making in VS management: 1-incidental VS; 2-tumor size; 3-tumor regrowth after sRT; 4-subtotal resection; 5-patients\' age; 6-symptoms. The initial search yielded 3532 articles, and finally, 812 articles were included. Through a qualitative synthesis of the included studies, management strategies were evaluated and discussed. An individualized proposal of procedures is preferable as compared to a single gold-standard approach in VS decision-making. The most significant factors that need to be considered when dealing with a VS diagnosis are age, tumor size and hearing preservation issues.
摘要：
前庭神经鞘瘤（VS）的管理是一个复杂的过程，旨在确定分割立体定向放射治疗（sRT）或显微外科切除或等待扫描（WS）的临床指征。审查的目的是澄清哪些患者和肿瘤参数可能导致不同的治疗选择。以期采用个性化的VS方法。2022年2月至3月，根据系统评价和荟萃分析标准的首选报告项目进行了系统评价。作者定义了似乎会影响VS管理决策的六个参数：1-偶然VS；2-肿瘤大小；sRT后3-肿瘤再生；4次全切除；5患者年龄；6症状。最初的搜索产生了3532篇文章，最后，包括812篇文章。通过对纳入研究的定性综合，对管理策略进行了评估和讨论。与VS决策中的单一黄金标准方法相比，个性化的程序建议更可取。在处理VS诊断时需要考虑的最重要因素是年龄，肿瘤大小和听力保护问题。
