{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:28Z","timestamp":1780099228776,"version":"3.54.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215123000786_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Stereotactic radiosurgery has been shown to be an effective method of managing vestibular schwannomas. The primary aim here is to establish the impact of pre-treatment fast-growing vestibular schwannomas on the efficacy of stereotactic radiosurgery.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000786_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>PubMed, Medline and Embase databases were used. The ROBINS-I (\u2018Risk Of Bias In Non-randomised Studies - of Interventions\u2019) tool was utilised to assess for risk of bias. Proportionate meta-analysis and sub-analysis for fast-growing tumours were performed to explore the success rate of stereotactic radiosurgery in stabilising or decreasing the tumour burden in vestibular schwannomas.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000786_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Four moderate risk studies were included in the analysis. Overall, 91 per cent (95 per cent confidence interval = 0.83\u20130.97, <jats:italic>p<\/jats:italic> &lt; 0.01, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 80 per cent) of the tumours demonstrated successful size reduction or stabilisation following stereotactic radiosurgery. Nevertheless, the efficacy of stereotactic radiosurgery in reducing or stabilising fast-growing vestibular schwannomas decreased by 79 per cent (95 per cent confidence interval = 0.64\u20130.91, <jats:italic>p<\/jats:italic> = 0.11, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 62 per cent).<\/jats:p><\/jats:sec><jats:sec id=\"S0022215123000786_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>Stereotactic radiosurgery has a statistically significant success rate in stabilising or decreasing the vestibular schwannoma size. This success rate is diminished in fast-growing vestibular schwannomas.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215123000786","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T09:39:07Z","timestamp":1684316347000},"page":"1193-1199","source":"Crossref","is-referenced-by-count":2,"title":["A systematic review and meta-analysis of stereotactic radiosurgery as a primary treatment in fast-growing vestibular schwannomas"],"prefix":"10.1017","volume":"137","author":[{"given":"Faizan","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne O W","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantina P","family":"Yiannakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6835-1304","authenticated-orcid":false,"given":"Mohd Afiq Mohd","family":"Slim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kontorinis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"S0022215123000786_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.02.019"},{"key":"S0022215123000786_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21908"},{"key":"S0022215123000786_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.04.008"},{"key":"S0022215123000786_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.03.047"},{"key":"S0022215123000786_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.01.038"},{"key":"S0022215123000786_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"S0022215123000786_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nor171"},{"key":"S0022215123000786_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(93)90343-T"},{"key":"S0022215123000786_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"S0022215123000786_ref27","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002910"},{"key":"S0022215123000786_ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0110823"},{"key":"S0022215123000786_ref26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2017-110853"},{"key":"S0022215123000786_ref1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2001.95.3.0440"},{"key":"S0022215123000786_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.01.001"},{"key":"S0022215123000786_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.06.089"},{"key":"S0022215123000786_ref22","volume-title":"Doing Meta-Analysis with R: A Hands-On Guide","author":"Harrer","year":"2022"},{"key":"S0022215123000786_ref28","first-page":"11","article-title":"Vestibular schwannoma tumor size and growth rate predict response with gamma knife stereotactic radiosurgery","volume":"83","author":"Killeen","year":"2020","journal-title":"J Neurol Surg B Skull Base"},{"key":"S0022215123000786_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2011.05.009"},{"key":"S0022215123000786_ref24","doi-asserted-by":"publisher","DOI":"10.3171\/2018.6.JNS18516"},{"key":"S0022215123000786_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-013-1924-5"},{"key":"S0022215123000786_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.02.017"},{"key":"S0022215123000786_ref12","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/55\/12\/001"},{"key":"S0022215123000786_ref16","doi-asserted-by":"publisher","DOI":"10.3171\/2016.5.JNS153013"},{"key":"S0022215123000786_ref20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"S0022215123000786_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200606000-00018"},{"key":"S0022215123000786_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2013.11.029"},{"key":"S0022215123000786_ref13","doi-asserted-by":"publisher","DOI":"10.3171\/2012.5.JNS111858"},{"key":"S0022215123000786_ref4","doi-asserted-by":"publisher","DOI":"10.3171\/2014.11.JNS14594"}],"container-title":["The Journal of Laryngology &amp; 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