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Abstract：
Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety.
To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS.
We performed a retrospective study of 267 patients with NF2 (328 VSs) who underwent single-session SRS at 12 centers participating in the International Radiosurgery Research Foundation. The median patient age was 31 years (IQR, 21-45 years), and 52% were male.
A total of 328 tumors underwent SRS during a median follow-up time of 59 months (IQR, 23-112 months). At 10 and 15 years, the tumor control rates were 77% (95% CI: 69%-84%) and 52% (95% CI: 40%-64%), respectively, and the FFAT rate were 85% (95% CI: 79%-90%) and 75% (95% CI: 65%-86%), respectively. At 5 and 10 years, the serviceable hearing preservation rates were 64% (95% CI: 55%-75%) and 35% (95% CI: 25%-54%), respectively. In the multivariate analysis, age (hazards ratio: 1.03 [95% CI: 1.01-1.05]; P = .02) and bilateral VSs (hazards ratio: 4.56 [95% CI: 1.05-19.78]; P = .04) were predictors for serviceable hearing loss. Neither radiation-induced tumors nor malignant transformation were encountered in this cohort.
Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.
To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS.
We performed a retrospective study of 267 patients with NF2 (328 VSs) who underwent single-session SRS at 12 centers participating in the International Radiosurgery Research Foundation. The median patient age was 31 years (IQR, 21-45 years), and 52% were male.
A total of 328 tumors underwent SRS during a median follow-up time of 59 months (IQR, 23-112 months). At 10 and 15 years, the tumor control rates were 77% (95% CI: 69%-84%) and 52% (95% CI: 40%-64%), respectively, and the FFAT rate were 85% (95% CI: 79%-90%) and 75% (95% CI: 65%-86%), respectively. At 5 and 10 years, the serviceable hearing preservation rates were 64% (95% CI: 55%-75%) and 35% (95% CI: 25%-54%), respectively. In the multivariate analysis, age (hazards ratio: 1.03 [95% CI: 1.01-1.05]; P = .02) and bilateral VSs (hazards ratio: 4.56 [95% CI: 1.05-19.78]; P = .04) were predictors for serviceable hearing loss. Neither radiation-induced tumors nor malignant transformation were encountered in this cohort.
Although the absolute volumetric tumor progression rate was 48% at 15 years, the rate of FFAT related to VS was 75% at 15 years after SRS. None of the patients with NF2-related VS developed a new radiation-related neoplasm or malignant transformation after SRS.
摘要：
背景：与2型神经纤维瘤病（NF2）相关的前庭神经鞘瘤（VS）是具有挑战性的肿瘤。立体定向放射外科（SRS）的使用越来越多，因此有必要对其作用和安全性进行进一步研究。
目的：为了评估肿瘤控制，免于额外治疗（FFAT），有用的听力保护，VSSRS后NF2患者的辐射相关风险。
方法：我们对参加国际放射外科研究基金会的12个中心的267例NF2（328例VSs）患者进行了一次SRS的回顾性研究。患者年龄中位数为31岁(IQR，21-45岁），52%是男性。
结果：在59个月的中位随访时间内，共有328个肿瘤接受了SRS（IQR，23-112个月）。在10年和15年，肿瘤控制率分别为77%(95%CI:69%-84%)和52%(95%CI:40%-64%),分别,FFAT率为85%(95%CI:79%-90%)和75%(95%CI:65%-86%)，分别。在5年和10年，可用的听力保持率为64％（95％CI：55％-75％）和35％（95％CI：25％-54％），分别。在多变量分析中，年龄(危险比:1.03[95%CI:1.01-1.05];P=.02)和双侧VSs(危险比:4.56[95%CI:1.05-19.78];P=.04)是有效听力损失的预测因素.在该队列中既没有遇到辐射诱导的肿瘤，也没有遇到恶性转化。
结论：尽管15年的绝对体积肿瘤进展率为48%，SRS后15年与VS相关的FFAT率为75%。与NF2相关的VS患者在SRS后均未出现新的与辐射相关的肿瘤或恶性转化。
目的：为了评估肿瘤控制，
方法：我们对参加国际放射外科研究基金会的12个中心的267例NF2（328例VSs）患者进行了一次SRS的回顾性研究。
结果：在59个月的中位随访时间内，共有328个肿瘤接受了SRS（IQR，
结论：尽管15年的绝对体积肿瘤进展率为48%，
