Universität zu Köln

Jakubeit, Thomas, Sturtz, Sibylle, Sow, Dorothea, Gross, Wolfram, Mosch, Christoph, Patt, Mattea, Weingaertner, Vera, Bostrom, Jan, Goldbrunner, Roland and Markes, Martina (2022). Single-fraction stereotactic radiosurgery versus microsurgical resection for the treatment of vestibular schwannoma: a systematic review and meta-analysis. Syst. Rev., 11 (1). LONDON: BMC. ISSN 2046-4053

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Abstract

Background: Vestibular schwannomas are benign tumours for which various treatments are available. We performed a systematic review of prospective controlled trials comparing the patient-relevant benefits and harms of single-fraction stereotactic radiosurgery (sfSRS) with microsurgical resection (MR) in patients with vestibular schwannoma. Methods: We searched for randomized controlled trials (RCTs) and non-randomized prospective controlled trials in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and study registries (last search: 09/2021) and also screened reference lists of relevant systematic reviews. Manufacturers were asked to provide unpublished data. Eligible studies investigated at least one patient-relevant outcome. We assessed the risk of bias (high or low) at the study and outcome level. If feasible, meta-analyses were performed. We graded the results into different categories (hint, indication, or proof of greater benefit or harm). Results: We identified three non-randomized prospective controlled trials of generally low quality with evaluable data on 339 patients with unilateral vestibular schwannoma. There was an indication of greater benefit of sfSRS compared with MR for facial palsy (OR 0.06, 95% CI 0.02-0.21, p < 0.001, 2 studies), hearing function (no pooled estimate available, 2 studies), and length of hospital stay (no pooled estimate available, 2 studies). We found no clinically relevant differences for mortality, vertigo, headaches, tinnitus, balance function, work disability, adverse events, and health-related quality of life. Conclusions: Our systematic review indicates that sfSRS has greater benefits than MR in patients with unilateral vestibular schwannoma. However, it is unclear whether this conclusion still holds after 2 years, as long-term studies are lacking. It is also unclear whether the effects of sfSRS are similar in patients with bilateral vestibular schwannomas. Long-term prospective studies including patients with this condition would therefore be useful.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jakubeit, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturtz, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Sow, Dorothea UNSPECIFIED UNSPECIFIED UNSPECIFIED Gross, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Mosch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Patt, Mattea UNSPECIFIED UNSPECIFIED UNSPECIFIED Weingaertner, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED Bostrom, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Markes, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-678851
DOI:	10.1186/s13643-022-02118-9
Journal or Publication Title:	Syst. Rev.
Volume:	11
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2046-4053
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EVIDENCE-BASED GUIDELINES; HEARING; MANAGEMENT; OUTCOMES; QUALITY Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67885