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Abstract：
Introduction CyberKnife (CK) radiosurgery is a treatment strategy for vestibular schwannoma (VS). Objectives To evaluate hearing preservation (HP) after CK for VS. Data Synthesis The study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, and it was registered at the International Prospective Register of Systematic Reviews (PROSPERO, under number CRD42021250300). The inclusion criteria were based on the population, intervention, comparison, outcome, timing and study design (PICOTS) strategy: population - patients with VS; intervention - CK; Comparison - none; Outcome - serviceable HP defined by Gardner and Robertson as grades I or II, or by the American Academy of Otolaryngology and Head and Neck Surgery as classes A or B; timing - mean follow-up longer than 1 year; and study design - retrospective or prospective studies. The exclusion criteria were: studies not published in English; studies published before January 2000 and after October 2021; and studies only including patients with neurofibromatosis type 2 or submitted to a previous treatment. The PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, LILACS, and IBECS databases were used and last searched on October 27th, 2021. Statistical heterogeneity was assessed using I 2 statistics. The appraisal checklist was used to assess the risk of bias in the included studies. A total of 222 studies were analyzed, and 13 were included in the synthesis, which represents 493 participants with serviceable hearing before intervention. The mean HP rate after CK using a random effects model was of 68% (95% confidence interval [95%CI]: 59-76%) at a mean follow-up of 42.96 months. Conclusion The longer follow-up period was associated with a lower HP rate after CK radiosurgery for VS in the qualitative synthesis.
摘要：
介绍射波刀（CK）放射外科是前庭神经鞘瘤（VS）的治疗策略。目的评价CK后的听力保护（HP）。数据综合本研究是根据系统评价和荟萃分析（PRISMA）声明的首选报告项目进行的。并在国际前瞻性系统审查登记册(PROSPERO，在编号CRD42021250300下)。纳入标准基于人群，干预，比较,结果,时间和研究设计（PICOTS）策略：人群-VS患者；干预-CK；比较-无；结果-Gardner和Robertson定义为I级或II级的可服务HP，或由美国耳鼻咽喉科和头颈外科学会作为A类或B类;时间-平均随访时间超过1年;和研究设计-回顾性或前瞻性研究。排除标准为：非英文发表的研究；2000年1月之前和2021年10月之后发表的研究；以及仅包括2型神经纤维瘤病患者或接受过先前治疗的患者的研究。PubMed/MEDLINE,EMBASE,WebofScience,科克伦图书馆,LILACS,和IBECS数据库被使用，最后一次搜索是在10月27日，2021年。使用I2统计数据评估统计异质性。评估清单用于评估纳入研究中的偏倚风险。共分析了222项研究，和13个被包括在合成中，这代表了493名参与者在干预前的可用听力。在平均随访42.96个月时，使用随机效应模型的CK后平均HP率为68％（95％置信区间[95CI]：59-76％）。结论在定性合成中，CK放射外科治疗VS后，随访时间越长，HP率越低。
