{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T08:24:13Z","timestamp":1783412653215,"version":"3.54.6"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French Society of Neurosurgery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The definition of tumor control and treatment failure after Gamma Knife 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 the evolution of tumor volume and characterize volumetric patterns.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included patients with sporadic VS treated by GKRS with an MRI follow-up of a minimum of 3 years. A clustering was performed in 2 steps: Definition of the patterns of evolution based on a subset of patients with the most comprehensive follow-up, and then the 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1607 patients were included (median follow-up: 67 months). Five patterns were defined with 1 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 as follows: sex, initial symptoms, delay of diagnosis, Koos grading, fundus invasion, and number of isocenters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The definition of these robust distinct patterns is likely to help the physicians tremendously 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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/neuonc\/noae187","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T18:26:57Z","timestamp":1726511217000},"page":"545-556","source":"Crossref","is-referenced-by-count":17,"title":["Dynamics of tumor evolution after Gamma Knife radiosurgery for sporadic vestibular schwannoma: Defining volumetric patterns characterizing individual trajectory"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-3766","authenticated-orcid":false,"given":"Anne","family":"Balossier","sequence":"first","affiliation":[{"name":"Aix Marseille University, INSERM, INS, Inst Neurosci Syst , Marseille ,","place":["France"]},{"name":"Functional and Stereotactic Neurosurgery, AP-HM, Timone Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Olteanu","sequence":"additional","affiliation":[{"name":"CEREMADE, UMR 7534, Universit\u00e9 Paris Dauphine PSL , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Delsanti","sequence":"additional","affiliation":[{"name":"Functional and Stereotactic Neurosurgery, AP-HM, Timone Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Troude","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, AP-HM, North University Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Thomassin","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, AP-HM, Timone Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Hugues","family":"Roche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, AP-HM, North University Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Chavent","sequence":"additional","affiliation":[{"name":"UMR5251, INRIA, Universit\u00e9 de Bordeaux , Talence ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"R\u00e9gis","sequence":"additional","affiliation":[{"name":"Aix Marseille University, INSERM, INS, Inst Neurosci Syst , Marseille ,","place":["France"]},{"name":"Functional and Stereotactic Neurosurgery, AP-HM, Timone Hospital , Marseille 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