{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:41:22Z","timestamp":1792201282329,"version":"4.4.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This report evaluates the outcomes of stereotactic radiosurgery (SRS) as the first-line treatment of intracanalicular vestibular schwannomas (VSs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Between 1987 and 2017, the authors identified 209 patients who underwent SRS as the primary intervention for a unilateral intracanalicular VS. The median patient age was 54 years (range 22\u201385 years); 94 patients were male and 115 were female. Three patients had facial neuropathy at the time of SRS. One hundred fifty-five patients (74%) had serviceable hearing (Gardner-Robertson [GR] grades I and II) at the time of SRS. The median tumor volume was 0.17 cm\n                      <jats:sup>3<\/jats:sup>\n                      (range 0.015\u20130.63 cm\n                      <jats:sup>3<\/jats:sup>\n                      ). The median margin dose was 12.5 Gy (range 11.0\u201325.0 Gy). The median maximum dose was 24.0 Gy (range 15.7\u201350.0 Gy).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The progression-free survival rates of all patients with intracanalicular VS were 97.5% at 3 years, 95.6% at 5 years, and 92.1% at 10 years. The rates of freedom from the need for any additional intervention were 99.4% at 3 years, 98.3% at 5 years, and 98.3% at 10 years. The serviceable hearing preservation rates in GR grade I and II patients at the time of SRS were 76.6% at 3 years, 63.5% at 5 years, and 27.3% at 10 years. In univariate analysis, younger age (&lt; 55 years, p = 0.011), better initial hearing (GR grade I, p &lt; 0.001), and smaller tumor volumes (&lt; 0.14 cm\n                      <jats:sup>3<\/jats:sup>\n                      , p = 0.016) were significantly associated with improved hearing preservation. In multivariate analysis, better hearing (GR grade I, p = 0.001, HR 2.869, 95% CI 1.569\u20135.248) and smaller tumor volumes (&lt; 0.14 cm\n                      <jats:sup>3<\/jats:sup>\n                      , p = 0.033, HR 2.071, 95% CI 1.059\u20134.047) at the time of SRS were significantly associated with improved hearing preservation. The hearing preservation rates of patients with GR grade I VS were 88.1% at 3 years, 77.9% at 5 years, and 38.1% at 10 years. The hearing preservation rates of patients with VSs smaller than 0.14 cm\n                      <jats:sup>3<\/jats:sup>\n                      were 85.5% at 3 years, 77.7% at 5 years, and 42.6% at 10 years. Facial neuropathy developed in 1.4% from 6 to 156 months after SRS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SRS provided sustained tumor control in more than 90% of patients with intracanalicular VS at 10 years and freedom from the need for additional intervention in more than 98% at 10 years. Patients with initially better hearing and smaller VSs had enhanced serviceable hearing preservation during an observation interval up to 10 years after SRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.9.jns202818","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T04:37:39Z","timestamp":1613709459000},"page":"1051-1057","source":"Crossref","is-referenced-by-count":27,"title":["Stereotactic radiosurgery as the first-line treatment for intracanalicular vestibular schwannomas"],"prefix":"10.3171","volume":"135","author":[{"given":"Akiyoshi","family":"Ogino","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and"},{"name":"Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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