Long-Term Quality of Life Following Stereotactic Radiosurgery for Vestibular Schwannoma

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
J. Thom ◽  
M. Carlson ◽  
J. Jacob ◽  
C. Driscoll ◽  
B. Neff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stereotactic Radiosurgery ◽  
Vestibular Schwannoma

scholarly journals Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls

2015 ◽  
Vol 122 (4) ◽  
pp. 833-842 ◽  
Author(s):  
Matthew L. Carlson ◽  
Oystein Vesterli Tveiten ◽  
Colin L. Driscoll ◽  
Frederik K. Goplen ◽  
Brian A. Neff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stereotactic Radiosurgery ◽  
Short Form ◽  
Individual Treatment ◽  
Control Group ◽  
Treatment Groups ◽  
Sf 36 ◽  
Disease Specific

OBJECT The optimal treatment for sporadic vestibular schwannoma (VS) is highly controversial. To date, the majority of studies comparing treatment modalities have focused on a narrow scope of technical outcomes including facial function, hearing status, and tumor control. Very few publications have investigated health-related quality of life (HRQOL) differences between individual treatment groups, and none have used a disease-specific HRQOL instrument. METHODS All patients with sporadic small- to medium-sized VSs who underwent primary microsurgery, stereotactic radiosurgery (SRS), or observation between 1998 and 2008 were identified. Subjects were surveyed via postal questionnaire using the 36-Item Short Form Health Survey (SF-36), the 10-item Patient-Reported Outcomes Measurement Information System short form (PROMIS-10), the Glasgow Benefit Inventory (GBI), and the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Additionally, a pool of general population adults was surveyed, providing a nontumor control group for comparison. RESULTS A total of 642 respondents were analyzed. The overall response rate for patients with VS was 79%, and the mean time interval between treatment and survey was 7.7 years. Using multivariate regression, there were no statistically significant differences between management groups with respect to the PROMIS-10 physical or mental health dimensions, the SF-36 Physical or Mental Component Summary scores, or the PANQOL general, anxiety, hearing, or energy subdomains. Patients who underwent SRS or observation reported a better total PANQOL score and higher PANQOL facial, balance, and pain subdomain scores than the microsurgical cohort (p < 0.02). The differences in scores between the nontumor control group and patients with VS were greater than differences observed between individual treatment groups for the majority of measures. CONCLUSIONS The differences in HRQOL outcomes following SRS, observation, and microsurgery for VS are small. Notably, the diagnosis of VS rather than treatment strategy most significantly impacts quality of life. Understanding that a large number of VSs do not grow following discovery, and that intervention does not confer a long-term HRQOL advantage, small- and medium-sized VS should be initially observed, while intervention should be reserved for patients with unequivocal tumor growth or intractable symptoms that are amenable to treatment. Future studies assessing HRQOL in VS patients should prioritize use of validated disease-specific measures, such as the PANQOL, given the significant limitations of generic instruments in distinguishing between treatment groups and tumor versus nontumor subjects.

scholarly journals Long-term Quality of Life Following Vestibular Schwannoma Excision Via the Translabyrinthine Approach

2017 ◽  
Vol 38 (8) ◽  
pp. 1165-1173 ◽  
Author(s):  
Stephen J. Broomfield ◽  
Ashish K. Mandavia ◽  
Jack S. Nicholson ◽  
Osama Mahmoud ◽  
Andrew T. King ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vestibular Schwannoma ◽  
Translabyrinthine Approach

scholarly journals Quality of Life in Patients with Vestibular Schwannomas Following Gross Total or Less than Gross Total Microsurgical Resection: Should We be Taking the Entire Tumor Out?

Neurosurgery ◽  
2017 ◽  
Vol 82 (4) ◽  
pp. 541-547 ◽  
Author(s):  
Michael J Link ◽  
Morten Lund-Johansen ◽  
Christine M Lohse ◽  
Colin L W Driscoll ◽  
Ehrling Myrseth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Facial Nerve ◽  
Vestibular Schwannoma ◽  
Well Being ◽  
Sf 36 ◽  
Patient Reported ◽  
Microsurgical Resection ◽  
Disease Specific

Abstract BACKGROUND The goal of microsurgical removal of a vestibular schwannoma is to completely remove the tumor, to provide long-term durable cure. In many cases, less than gross total resection (GTR) is performed to preserve neurological, and especially facial nerve function. OBJECTIVE To analyze long-term quality of life (QoL) in a cohort of patients who received either GTR or less than GTR. METHODS Patients operated for vestibular schwannoma less than 3.0 cm in posterior fossa diameter at 1 of 2 international tertiary care centers were surveyed using generic and disease-specific QoL instruments. RESULTS A total of 143 patients were analyzed. GTR was performed in 122, and 21 underwent less than GTR. QoL was assessed at a mean of 7.7 yr after surgery (interquartile range: 5.7-9.6). Patients who underwent GTR had smaller tumors; otherwise, there were no baseline differences between groups. Patients who underwent GTR, after multivariable adjustment for baseline features and facial nerve and hearing outcomes, reported statistically significantly better Short Form Health Survey-36 (SF-36) physical and mental scores, Patient-Reported Outcomes Measurement Information System (PROMIS-10) physical and mental scores, and Penn Acoustic Neuroma Quality of Life (PANQOL) facial, energy, general health, and total scores compared to patients receiving less than GTR. CONCLUSION GTR is associated with better QoL using the general QoL measures SF-36 and PROMIS-10 and the disease-specific PANQOL, even after controlling for baseline and outcome differences. This is especially significant in the assessment of mental health, indicating there may indeed be a psychological advantage to the patient that translates to overall well-being to have the entire tumor removed if microsurgical resection is undertaken.

scholarly journals Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing's syndrome

2011 ◽  
Vol 165 (4) ◽  
pp. 527-535 ◽  
Author(s):  
Jitske Tiemensma ◽  
Adrian A Kaptein ◽  
Alberto M Pereira ◽  
Johannes W A Smit ◽  
Johannes A Romijn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vestibular Schwannoma ◽  
Cushing’S Syndrome ◽  
Intervention Program ◽  
Illness Perceptions ◽  
Illness Perception ◽  
Cushing's Syndrome ◽  
Chronic Obstructive

ObjectiveIllness perceptions pertain to the pattern of beliefs patients develop about their illness. Illness perceptions are determinants of quality of life (QoL). Factors contributing to persisting impaired QoL after Cushing's syndrome (CS) remain largely unknown. Therefore, the objective of this study was to explore illness perceptions, as potentially modifiable psychological factors, in relation to QoL in patients with long-term remission of CS.DesignCross-sectional study.MethodsWe included patients with long-term remission of CS (n=52). Illness perceptions were evaluated using the Illness Perception Questionnaire (IPQ)-Revised, and QoL was measured using the physical symptom checklist, EuroQoL-5D (EQ-5D), and the CushingQoL. Reference data were derived from recent studies and included patients with vestibular schwannoma (n=80), acute (n=35) or chronic (n=63) pain, and chronic obstructive pulmonary disease (COPD; n=171).ResultsIllness perceptions showed a strong correlation with QoL. Patients with CS scored distinctively more negative on the IPQ compared with patients with vestibular schwannoma and patients with acute pain, and also reported more illness-related complaints (all P<0.01). There were also some differences in illness perceptions between patients with CS and patients with chronic pain and patients with COPD, but there was no distinct pattern.ConclusionsPatients after long-term remission of CS report more negative illness perceptions compared with patients with other acute or chronic conditions. Further research is needed to assess whether QoL in CS can be improved by addressing these illness perceptions, for example, by a self-management intervention program.

scholarly journals Longitudinal Changes of Quality of Life and Hearing Following Radiosurgery for Vestibular Schwannoma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1315
Author(s):  
Paul Windisch ◽  
Jörg-Christian Tonn ◽  
Christoph Fürweger ◽  
Felix Ehret ◽  
Berndt Wowra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stereotactic Radiosurgery ◽  
Vestibular Schwannoma ◽  
Health Survey ◽  
Short Form ◽  
Hearing Threshold ◽  
Composite Score ◽  
Mental Composite Score

Background: Most existing publications on quality of life (QoL) following stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) gather information retrospectively by conducting surveys several years after treatment. The purpose of this study is therefore to provide longitudinal QoL data and assess how changes in hearing impact QoL. Methods: Patients completed the 12-item short-form (SF-12) health survey prior to treatment and at every follow-up visit. One hundred and seventy-five patients who had complete forms prior to treatment as well as at an early and at a late follow-up were included in the analysis. For 51 of these patients, longitudinal audiometry data were available. Results: Median follow-up was 7.2 years. Patients experienced a significant reduction in the physical composite score (PCS, p = 0.011) compared to before treatment. The mental composite score (MCS) increased significantly (p = 0.032). A decrease in PCS was not significantly correlated with an increased hearing threshold on the affected but rather on the unaffected ear (r(49) = −0.32, p = 0.023). Conclusions: It is unclear whether the decline in the PCS is due to treatment-related toxicity or the normal decline of PCS with age. Ensuring proper hearing on the untreated ear might be crucial to ensure good QoL for patients treated with SRS for VS, though this association should be confirmed in additional studies.

Long-Term Quality of Life in Vestibular Schwannoma: Impact of Disease and Treatment

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Matthew Carlson ◽  
Øystein Tveiten ◽  
Colin Driscoll ◽  
Morten Lund-Johansen ◽  
Michael Link
Keyword(s):  
Quality Of Life ◽  
Vestibular Schwannoma
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