title: Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient's perspective.
abstract: This study evaluates the impact of gamma knife radiosurgery (GKRS) on the quality of life (QOL) of patients with a sporadic vestibular schwannoma (VS). This study pertains to 108 VS patients who had GKRS in the years 2003 through 2007. Two different QOL questionnaires were used: medical outcome study short form 36 (SF36) and Glasgow benefit inventory (GBI). Radiosurgery was performed using a Leksell 4C gamma knife. The results of the QOL questionnaires in relation to prospectively and retrospectively gathered data of the VS patients treated by GKRS. Eventually, 97 patients could be included in the study. Their mean tumor size was 17 mm (range 6-39 mm); the mean maximum dose on the tumor was 19.9 Gy (range 16-25.5 Gy) and the mean marginal dose on the tumor was 11.1 (range 9.3-12.5 Gy). SF36 scores showed results comparable to those for a normal Dutch population. GBI showed a marginal decline in QOL. No correlation was found between QOL and gender, age, tumor size, or radiation dose. Increased audiovestibular symptoms after GKRS were correlated with a decreased GBI score, and decreased symptoms were correlated with a higher QOL post-GKRS. In this study shows that GKRS for VS has little impact on the general QOL of the VS patient. However, there is a wide range in individual QOL results. Individual QOL was influenced by the audiovestibular symptoms. No predictive patient, tumor, or treatment factors for QOL outcome after GKRS could be determined. Comparison with microsurgery is difficult because of intra group variability.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, PO BOX 9101, 6500 HB, Nijmegen, The Netherlands. f.timmer@kno.umcn.nl
authors.forename: Ferdinand C A
authors.initials: FC
authors.lastname: Timmer
authors.forename: Anniek E P
authors.initials: AE
authors.lastname: van Haren
authors.forename: Jef J S
authors.initials: JJ
authors.lastname: Mulder
authors.forename: Patrick E J
authors.initials: PE
authors.lastname: Hanssens
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: van Overbeeke
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
authors.forename: Kees
authors.initials: K
authors.lastname: Graamans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000523:psychology* / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D016634:Radiosurgery / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult