Prospective comparison of quality of life before and after observation, radiation, or surgery for vestibular schwannomas.

Full Abstract

OBJECT: The best management strategy for small-to medium-sized vestibular schwannomas (VSs) remains controversial between observation, radiation, and microsurgical resection (surgery). The authors undertook a prospective observational cohort study comparing all 3 therapeutic modalities in patients with VSs, focusing on quality of life (QOL) outcomes. METHODS: All patients in the study completed the 36-Item Short Form Health Survey at regular intervals, with a mean follow-up of 31.8 months. Two hundred five (77.7%) of 264 patients completed questionnaires, including 47 who underwent observation, 48 who received either linear accelerator radiosurgery or fractionated radiotherapy (radiation group), and 134 who underwent surgery (of whom 37 had tumors > 3 cm in diameter). Patients allocated to the observation group had smaller tumors than those in the other groups (mean 1.3 cm; p < 0.001). Patients who received radiation were older than patients in the other groups (mean 60.0 years; p < 0.001). RESULTS: There were no baseline QOL differences between the observation, radiation, and surgery (tumors 3 cm, there was an early improvement in composite mental dimension at 1.5 months, as well as at 24 months; total score and composite physical dimension were improved at 24 months in this group as well. CONCLUSIONS: Based on the current management protocol, patients with VSs enjoy similar QOL throughout the follow-up period after undergoing observation, radiation therapy, or surgery.

Author information

Author/s: Di Maio, Salvatore (S); Akagami, Ryojo (R);

Affiliation: Division of Neurosurgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Journal of neurosurgery (J Neurosurg), published in United States. (Language: eng)

Reference: 2009-Oct; vol 111 (issue 4) : pp 855-62

Dates: Created 2009/10/02; Completed 2009/10/23;

PMID: 19301957, status: MEDLINE (last retrieval date: 10/23/2009, IMS Date: )

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