Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria
(1) Background: Transient increase in volume of vestibular schwannomas (VS) after stereotactic radiosurgery (SRS) is common and complicates differentiation between treatment-related changes (pseudoprogression, PP) and tumor recurrence (progressive disease, PD). (2) Methods: Patients with unilateral...
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/5/1496 |
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| author | Daniel Rueß Betina Schütz Eren Celik Christian Baues Stephanie T. Jünger Volker Neuschmelting Alexandra Hellerbach Markus Eichner Martin Kocher Maximilian I. Ruge |
| author_facet | Daniel Rueß Betina Schütz Eren Celik Christian Baues Stephanie T. Jünger Volker Neuschmelting Alexandra Hellerbach Markus Eichner Martin Kocher Maximilian I. Ruge |
| author_sort | Daniel Rueß |
| collection | DOAJ |
| description | (1) Background: Transient increase in volume of vestibular schwannomas (VS) after stereotactic radiosurgery (SRS) is common and complicates differentiation between treatment-related changes (pseudoprogression, PP) and tumor recurrence (progressive disease, PD). (2) Methods: Patients with unilateral VS (n = 63) underwent single fraction robotic-guided SRS. Volume changes were classified according to existing RANO criteria. A new response type, PP, with a >20% transient increase in volume was defined and divided into early (within the first 12 months) and late (>12 months) occurrence. (3) Results: The median age was 56 (range: 20–82) years, the median initial tumor volume was 1.5 (range: 0.1–8.6) cm<sup>3</sup>. The median radiological and clinical follow-up time was 66 (range: 24–103) months. Partial response was observed in 36% (n = 23), stable disease in 35% (n = 22) and PP in 29% (n = 18) of patients. The latter occurred early (16%, n = 10) or late (13%, n = 8). Using these criteria, no case of PD was observed. (4) Conclusion: Any volume increase after SRS for vs. assumed to be PD turned out to be early or late PP. Therefore, we propose modifying RANO criteria for SRS of VS, which may affect the management of vs. during follow-up in favor of further observation. |
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| language | English |
| last_indexed | 2024-03-11T07:29:23Z |
| publishDate | 2023-02-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-0980f98eb2de4a7f9c9e7b8c7604d8712023-11-17T07:24:56ZengMDPI AGCancers2072-66942023-02-01155149610.3390/cancers15051496Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response CriteriaDaniel Rueß0Betina Schütz1Eren Celik2Christian Baues3Stephanie T. Jünger4Volker Neuschmelting5Alexandra Hellerbach6Markus Eichner7Martin Kocher8Maximilian I. Ruge9Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Radiation Oncology, Cyberknife and Radiation Therapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Radiation Oncology, Cyberknife and Radiation Therapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, GermanyDepartment of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener St. 62, 50937 Cologne, Germany(1) Background: Transient increase in volume of vestibular schwannomas (VS) after stereotactic radiosurgery (SRS) is common and complicates differentiation between treatment-related changes (pseudoprogression, PP) and tumor recurrence (progressive disease, PD). (2) Methods: Patients with unilateral VS (n = 63) underwent single fraction robotic-guided SRS. Volume changes were classified according to existing RANO criteria. A new response type, PP, with a >20% transient increase in volume was defined and divided into early (within the first 12 months) and late (>12 months) occurrence. (3) Results: The median age was 56 (range: 20–82) years, the median initial tumor volume was 1.5 (range: 0.1–8.6) cm<sup>3</sup>. The median radiological and clinical follow-up time was 66 (range: 24–103) months. Partial response was observed in 36% (n = 23), stable disease in 35% (n = 22) and PP in 29% (n = 18) of patients. The latter occurred early (16%, n = 10) or late (13%, n = 8). Using these criteria, no case of PD was observed. (4) Conclusion: Any volume increase after SRS for vs. assumed to be PD turned out to be early or late PP. Therefore, we propose modifying RANO criteria for SRS of VS, which may affect the management of vs. during follow-up in favor of further observation.https://www.mdpi.com/2072-6694/15/5/1496radiosurgeryvestibular schwannomaCyberknife<sup>®</sup>skull base tumorsRANO criteria |
| spellingShingle | Daniel Rueß Betina Schütz Eren Celik Christian Baues Stephanie T. Jünger Volker Neuschmelting Alexandra Hellerbach Markus Eichner Martin Kocher Maximilian I. Ruge Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria Cancers radiosurgery vestibular schwannoma Cyberknife<sup>®</sup> skull base tumors RANO criteria |
| title | Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria |
| title_full | Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria |
| title_fullStr | Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria |
| title_full_unstemmed | Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria |
| title_short | Pseudoprogression of Vestibular Schwannoma after Stereotactic Radiosurgery with Cyberknife<sup>®</sup>: Proposal for New Response Criteria |
| title_sort | pseudoprogression of vestibular schwannoma after stereotactic radiosurgery with cyberknife sup r sup proposal for new response criteria |
| topic | radiosurgery vestibular schwannoma Cyberknife<sup>®</sup> skull base tumors RANO criteria |
| url | https://www.mdpi.com/2072-6694/15/5/1496 |
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