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Predictors of Growth of Vestibular Schwannoma After Gamma Knife Treatment: A Systematic Review
by
, , ,
Cheng Yang
1,2,*,†
,
Daniel Alvarado
1,2,†,
Pawan Kishore Ravindran
1,2,
Max E. Keizer
1,2,
Koos Hovinga
1,2,
Martinus P. G. Broen
3,
Danielle Eekers
2,4,
Inge Compter
2,4,
Henricus P. M. Kunst
5,6,7 and 
Yasin Temel
1,2,8,* 
1
Department of Neurosurgery, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
2
Dutch Academic Alliance Skull Base Pathology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
3
Department of Neurology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
4
Department of Radiation Oncology (MAASTRO), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
5
Department of Otorhinolaryngology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
6
Department of Otorhinolaryngology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
7
Dutch Academic Alliance Skull Base Pathology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
8
Istanbul Atlas University, 34406 Istanbul, Turkey
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2025, 17(12), 1993; https://doi.org/10.3390/cancers17121993 (registering DOI)
Submission received: 30 April 2025
/
Revised: 9 June 2025
/
Accepted: 12 June 2025
/
Published: 14 June 2025
(This article belongs to the Section Cancer Therapy)
Simple Summary
Gamma Knife radiosurgery (GKRS) effectively controls vestibular schwannoma growth, yet some tumors still progress after treatment. This systematic review analyzed predictors of post-GKRS growth, including patient demographics, tumor characteristics, and imaging biomarkers. We found that initial tumor volume, pretreatment growth rate, and MRI features were significant predictors of regrowth. Understanding these factors may improve personalized treatment strategies and outcomes for patients undergoing GKRS for vestibular schwannoma.
Abstract
Background: GKRS shows a high success rate in controlling growth of vestibular schwannoma, but a small number of tumors still grow after treatment. However, only a few studies have investigated the predictive factors of this growth. Objective: Here, we aim to explore the growth determinants of vestibular schwannoma after GKRS. Methods: This paper has analyzed literature published between 2000 and 2024 from PubMed, EMBASE, and Cochrane databases. Potential determinants, including age, gender, tumor volume, radiation dose, tumor location, and imaging characteristics, have been reviewed. Conclusions: We have found that initial tumor volume, pretreatment growth rate, and imaging ADC value potentially predict growth after GKRS. These findings provide a reference for further optimizing personalized treatment in vestibular schwannoma care.
Keywords:
systematic review; vestibular schwannoma; growth rate; Gamma Knife; skull base; factors
