Anne Balossier, Madalina Olteanu, Christine Delsanti, Lucas Troude, Jean-Marc Thomassin, Pierre-Hugues Roche, Marie Chavent, Jean Régis
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引用次数: 0
Abstract
Background: Definition of tumor control and treatment failure after Gammaknife radiosurgery (GKRS) for vestibular schwannoma (VS) is still debated. The lack of knowledge on the dynamics of tumor evolution can lead to misinterpretation and subsequent inappropriate second treatment. The aim of this study was to evaluate the post-GKRS dynamics of evolution of tumor volume, and characterize volumetric patterns.
Methods: We included patients with sporadic VS treated by GKRS with an MRI follow-up of minimum 3 years. A clustering in 2 steps was performed: definition of the patterns of evolution based on a subset of patients with the most comprehensive follow-up, then assignment of the remaining patients on a best fit basis. The minimum length of follow-up was assessed by measuring the consistency of the clusters over time (Adjusted Rand Index and Normalized Mutual Information). An analysis of the discriminant variables was finally performed.
Results: 1,607 patients were included (median follow-up: 67 months). Five patterns were defined with one pattern gathering almost all cases of treatment failure. The clustering at 5 years afforded the highest consistency with long-term follow-up. Discriminant variables for clusters were: sex, initial symptoms, delay of diagnosis, Koos grading, fundus invasion, and number of isocenters.
Conclusions: The definition of these robust distinct patterns is likely to help tremendously the physicians to distinguish tumor control from potential failure. We advocate for no retreatment decision before 5 years post-GKRS. Further investigations are required to decide if the dynamics of evolution can be predicted at GKRS on an individual basis.
ACS Energy Letters Energy-Renewable Energy, Sustainability and the Environment
CiteScore
31.20
自引率
5.00%
发文量
469
审稿时长
1 months
期刊介绍:
ACS Energy Letters is a monthly journal that publishes papers reporting new scientific advances in energy research. The journal focuses on topics that are of interest to scientists working in the fundamental and applied sciences. Rapid publication is a central criterion for acceptance, and the journal is known for its quick publication times, with an average of 4-6 weeks from submission to web publication in As Soon As Publishable format.
ACS Energy Letters is ranked as the number one journal in the Web of Science Electrochemistry category. It also ranks within the top 10 journals for Physical Chemistry, Energy & Fuels, and Nanoscience & Nanotechnology.
The journal offers several types of articles, including Letters, Energy Express, Perspectives, Reviews, Editorials, Viewpoints and Energy Focus. Additionally, authors have the option to submit videos that summarize or support the information presented in a Perspective or Review article, which can be highlighted on the journal's website. ACS Energy Letters is abstracted and indexed in Chemical Abstracts Service/SciFinder, EBSCO-summon, PubMed, Web of Science, Scopus and Portico.