Impact of the Mean Cochlear Biologically Effective Dose on Hearing Preservation After Stereotactic Radiosurgery for Vestibular Schwannoma: A Retrospective Longitudinal Analysis.
Details
Serval ID
serval:BIB_91D8B7537F40
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of the Mean Cochlear Biologically Effective Dose on Hearing Preservation After Stereotactic Radiosurgery for Vestibular Schwannoma: A Retrospective Longitudinal Analysis.
Journal
Neurosurgery
ISSN
1524-4040 (Electronic)
ISSN-L
0148-396X
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Publication Status: aheadofprint
Abstract
Stereotactic radiosurgery (SRS) is a useful alternative for small- to medium-sized vestibular schwannoma. To evaluate whether biologically effective dose (BEDGy2.47), calculated for mean (BEDGy2.47 mean) and maximal (BEDGy2.47 max) cochlear dose, is relevant for hearing preservation.
This is a retrospective longitudinal single-center study. Were analyzed 213 patients with useful baseline hearing. Risk of hearing decline was assessed for Gardner-Robertson classes and pure tone average (PTA) loss. The mean follow-up period was 39 months (median 36, 6-84).
Hearing decline (Gardner-Robertson class) 3 years after SRS was associated with higher cochlear BEDGy2.47 mean (odds ratio [OR] 1.39, P = .009). Moreover, BEDGy2.47 mean was more relevant as compared with BEDGy2.47 max (OR 1.13, P = .04). Risk of PTA loss (continuous outcome, follow-up minus baseline) was significantly corelated with BEDGy2.47 mean at 24 (beta coefficient 1.55, P = .002) and 36 (beta coefficient 2.01, P = .004) months after SRS. Risk of PTA loss (>20 dB vs ≤) was associated with higher BEDGy2.47 mean at 6 (OR 1.36, P = .002), 12 (OR 1.36, P = .007), and 36 (OR 1.37, P = .02) months. Risk of hearing decline at 36 months for the BEDGy2.47 mean of 7-8, 10, and 12 Gy2.47 was 28%, 57%, and 85%, respectively.
Cochlear BEDGy2.47 mean is relevant for hearing decline after SRS and more relevant as compared with BEDGy2.47 max. Three years after SRS, this was sustained for all hearing decline evaluation modalities. Our data suggest the BEDGy2.47 mean cut-off of ≤8 Gy2.47 for better hearing preservation rates.
This is a retrospective longitudinal single-center study. Were analyzed 213 patients with useful baseline hearing. Risk of hearing decline was assessed for Gardner-Robertson classes and pure tone average (PTA) loss. The mean follow-up period was 39 months (median 36, 6-84).
Hearing decline (Gardner-Robertson class) 3 years after SRS was associated with higher cochlear BEDGy2.47 mean (odds ratio [OR] 1.39, P = .009). Moreover, BEDGy2.47 mean was more relevant as compared with BEDGy2.47 max (OR 1.13, P = .04). Risk of PTA loss (continuous outcome, follow-up minus baseline) was significantly corelated with BEDGy2.47 mean at 24 (beta coefficient 1.55, P = .002) and 36 (beta coefficient 2.01, P = .004) months after SRS. Risk of PTA loss (>20 dB vs ≤) was associated with higher BEDGy2.47 mean at 6 (OR 1.36, P = .002), 12 (OR 1.36, P = .007), and 36 (OR 1.37, P = .02) months. Risk of hearing decline at 36 months for the BEDGy2.47 mean of 7-8, 10, and 12 Gy2.47 was 28%, 57%, and 85%, respectively.
Cochlear BEDGy2.47 mean is relevant for hearing decline after SRS and more relevant as compared with BEDGy2.47 max. Three years after SRS, this was sustained for all hearing decline evaluation modalities. Our data suggest the BEDGy2.47 mean cut-off of ≤8 Gy2.47 for better hearing preservation rates.
Pubmed
Open Access
Yes
Create date
13/07/2023 14:06
Last modification date
27/07/2023 6:57