{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:27:56Z","timestamp":1784010476287,"version":"3.55.0"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective of this study was to describe the long-term efficacy of single-fraction stereotactic radiosurgery (SRS) for the primary treatment of sporadic vestibular schwannoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Adult (\u2265 18 years of age) patients with sporadic vestibular schwannoma who underwent SRS from 2000 through 2022 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 749 patients met inclusion criteria, the majority (n = 566, 76%) of whom had tumors extending into the cerebellopontine angle at SRS. The median patient age at SRS was 62 years, half (50%) of the patients were women, and 744 (99%) exhibited House-Brackmann grade I facial nerve function at SRS. A total of 42 patients experienced radiosurgical failure and underwent salvage treatment; the median duration of follow-up for the patients who did not undergo salvage treatment was 7.0 years. Overall tumor control rates (95% CI, number still at risk) at 1, 3, 5, 10, and 15 years after SRS were 100% (100%\u2013100%, 718), 98% (97%\u201399%, 589), 96% (94%\u201397%, 464), 92% (90%\u201395%, 258), and 91% (89%\u201394%, 125), respectively. Patient age (hazard ratio [HR] for a 10-year increase of 0.92, 95% CI 0.71\u20131.19; p = 0.5), presence of a macrocystic tumor (HR 0.59, 95% CI 0.14\u20132.46; p = 0.5), and treated tumor volume (HR for a 1-cm\n                      <jats:sup>3<\/jats:sup>\n                      increase of 1.02, 95% CI 0.88\u20131.18; p = 0.8) were not significantly associated with the risk of salvage. Three distinct post-SRS tumor behavior patterns were observed, with 13% of patients demonstrating tumor pseudoprogression, all but 4 of whom demonstrated pseudoprogression by year 5 post-SRS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SRS demonstrates durable tumor control through 15 years of follow-up in most patients (91%); however, a minority are found to still experience SRS failure even beyond 10 years of surveillance. Although occurring in only a minority of patients, tumor pseudoprogression can be evident out to 5 years or longer post-SRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.8.jns25829","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:23Z","timestamp":1769083223000},"page":"965-971","source":"Crossref","is-referenced-by-count":1,"title":["Long-term tumor control after Gamma Knife radiosurgery for sporadic vestibular schwannoma"],"prefix":"10.3171","volume":"144","author":[{"given":"John P.","family":"Marinelli","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazal S.","family":"Daher","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl R.","family":"Khandalavala","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Babajanian","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Dornhoffer","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Health Sciences Research,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, and"},{"name":"Radiation Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Brown","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Peris Celda","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Neff","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin L. W.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery,"},{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"14","key":"b1","series-title":"N Engl J Med","first-page":"1335","article-title":"Vestibular schwannomas","volume":"384","author":"Carlson ML","year":"2021","unstructured":"Carlson ML, Link MJ. Vestibular schwannomas. N Engl J Med. 2021;384(14):1335\u20131348."},{"issue":"8","key":"b2","series-title":"Historical article. J R Soc Med","first-page":"464P","article-title":"The bloody angle: 100 years of acoustic neuroma surgery","volume":"88","author":"Ramsden RT","year":"1995","unstructured":"Ramsden RT. The bloody angle: 100 years of acoustic neuroma surgery. Historical article. J R Soc Med. 1995;88(8):464P\u2013468P."},{"key":"b3","series-title":"Clin Epidemiol","first-page":"981","article-title":"Epidemiology of vestibular schwannomas\u2014prospective 40-year data from an unselected national cohort","volume":"11","author":"Reznitsky M","year":"2019","unstructured":"Reznitsky M, Petersen M, West N, Stangerup SE, Caye-Thomasen P. Epidemiology of vestibular schwannomas\u2014prospective 40-year data from an unselected national cohort. Clin Epidemiol. 2019;11:981\u2013986."},{"issue":"4","key":"b4","series-title":"Otolaryngol Head Neck Surg","first-page":"717","article-title":"Incidence of vestibular schwannoma over the past half-century: a population-based study of Olmsted County, Minnesota","volume":"159","author":"Marinelli JP","year":"2018","unstructured":"Marinelli JP, Lohse CM, Carlson ML. Incidence of vestibular schwannoma over the past half-century: a population-based study of Olmsted County, Minnesota. Otolaryngol Head Neck Surg. 2018;159(4):717\u2013723."},{"issue":"2","key":"b5","series-title":"Otolaryngol Head Neck Surg","first-page":"209","article-title":"Global incidence of sporadic vestibular schwannoma: a systematic review","volume":"167","author":"Marinelli JP","year":"2022","unstructured":"Marinelli JP, Beeler CJ, Carlson ML, Caye-Thomasen P, Spear SA, Erbele ID. Global incidence of sporadic vestibular schwannoma: a systematic review. 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Laryngoscope. 2019;129(5):1197\u20131205."},{"issue":"2","key":"b8","series-title":"J Neurooncol","first-page":"247","article-title":"Long term results of primary radiosurgery for vestibular schwannomas","volume":"145","author":"Johnson S","year":"2019","unstructured":"Johnson S, Kano H, Faramand A,  Long term results of primary radiosurgery for vestibular schwannomas. J Neurooncol. 2019;145(2):247\u2013255."},{"issue":"3","key":"b9","series-title":"Int J Radiat Oncol Biol Phys","first-page":"725","article-title":"Long-term outcomes of sporadic vestibular schwannomas treated with recent stereotactic radiosurgery techniques","volume":"108","author":"Hasegawa T","year":"2020","unstructured":"Hasegawa T, Kato T, Naito T,  Long-term outcomes of sporadic vestibular schwannomas treated with recent stereotactic radiosurgery techniques. Int J Radiat Oncol Biol Phys. 2020;108(3):725\u2013733."},{"issue":"6","key":"b10","series-title":"Neurosurgery","first-page":"E1084","article-title":"Treatment outcomes and dose rate effects following Gamma Knife stereotactic radiosurgery for vestibular schwannomas","volume":"85","author":"Smith DR","year":"2019","unstructured":"Smith DR, Saadatmand HJ, Wu CC,  Treatment outcomes and dose rate effects following Gamma Knife stereotactic radiosurgery for vestibular schwannomas. Neurosurgery. 2019;85(6):E1084\u2013E1094."},{"issue":"2","key":"b11","series-title":"Neuro Oncol","first-page":"545","article-title":"Dynamics of tumor evolution after Gamma Knife radiosurgery for sporadic vestibular schwannoma: defining volumetric patterns characterizing individual trajectory","volume":"27","author":"Balossier A","year":"2025","unstructured":"Balossier A, Olteanu M, Delsanti C,  Dynamics of tumor evolution after Gamma Knife radiosurgery for sporadic vestibular schwannoma: defining volumetric patterns characterizing individual trajectory. Neuro Oncol. 2025;27(2):545\u2013556."},{"issue":"5","key":"b12","series-title":"Otolaryngol Head Neck Surg","first-page":"803","article-title":"A new standardized format for reporting hearing outcome in clinical trials","volume":"147","author":"Gurgel RK","year":"2012","unstructured":"Gurgel RK, Jackler RK, Dobie RA, Popelka GR. A new standardized format for reporting hearing outcome in clinical trials. Otolaryngol Head Neck Surg. 2012;147(5):803\u2013807."},{"issue":"1","key":"b13","series-title":"Otolaryngol Head Neck Surg","first-page":"102","article-title":"Is it valid to calculate the 3-kilohertz threshold by averaging 2 and 4 kilohertz?","volume":"147","author":"Gurgel RK","year":"2012","unstructured":"Gurgel RK, Popelka GR, Oghalai JS, Blevins NH, Chang KW, Jackler RK. Is it valid to calculate the 3-kilohertz threshold by averaging 2 and 4 kilohertz? Otolaryngol Head Neck Surg. 2012;147(1):102\u2013104."},{"issue":"3","key":"b14","series-title":"Otolaryngol Head Neck Surg","first-page":"179","article-title":"Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma)","volume":"113","year":"1995","unstructured":"Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC. Otolaryngol Head Neck Surg. 1995;113(3):179\u2013180."},{"issue":"2","key":"b15","series-title":"Otolaryngol Head Neck Surg","first-page":"146","article-title":"Facial nerve grading system","volume":"93","author":"House JW","year":"1985","unstructured":"House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146\u2013147."},{"issue":"3","key":"b16","series-title":"Otolaryngol Head Neck Surg","first-page":"967","article-title":"Associations of microvascular risk factors with sporadic vestibular schwannoma outcomes following stereotactic radiosurgery","volume":"172","author":"Dornhoffer JR","year":"2025","unstructured":"Dornhoffer JR, Babajanian EE, Khandalavala KR,  Associations of microvascular risk factors with sporadic vestibular schwannoma outcomes following stereotactic radiosurgery. Otolaryngol Head Neck Surg. 2025;172(3):967\u2013973."},{"issue":"4","key":"b17","series-title":"J Neurosurg","first-page":"1141","article-title":"Minimum cochlear dose impacts hearing after radiosurgery for sporadic vestibular schwannoma","volume":"142","author":"Morshed RA","year":"2025","unstructured":"Morshed RA, Khandalavala KR, Dornhoffer JR,  Minimum cochlear dose impacts hearing after radiosurgery for sporadic vestibular schwannoma. J Neurosurg. 2025;142(4):1141\u20131148."},{"issue":"suppl","key":"b18","series-title":"J Neurosurg","first-page":"57","article-title":"Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma","volume":"117","author":"Sun S","year":"2012","unstructured":"Sun S, Liu A. Long-term follow-up studies of Gamma Knife surgery with a low margin dose for vestibular schwannoma. J Neurosurg. 2012;117(suppl):57\u201362."},{"issue":"10","key":"b19","series-title":"Otol Neurotol","first-page":"e1314","article-title":"Long-term outcomes of Gamma Knife radiosurgery for treating vestibular schwannoma with a lower prescription dose of 12 Gy compared with higher dose treatment","volume":"41","author":"Kawashima M","year":"2020","unstructured":"Kawashima M, Hasegawa H, Shin M,  Long-term outcomes of Gamma Knife radiosurgery for treating vestibular schwannoma with a lower prescription dose of 12 Gy compared with higher dose treatment. Otol Neurotol. 2020;41(10):e1314\u2013e1320."},{"issue":"1","key":"b20","series-title":"Neurosurgery","first-page":"123","article-title":"Temporal dynamics of pseudoprogression after Gamma Knife radiosurgery for vestibular schwannomas\u2014a retrospective volumetric study","volume":"84","author":"Breshears JD","year":"2019","unstructured":"Breshears JD, Chang J, Molinaro AM,  Temporal dynamics of pseudoprogression after Gamma Knife radiosurgery for vestibular schwannomas\u2014a retrospective volumetric study. Neurosurgery. 2019;84(1):123\u2013131."},{"key":"b21","series-title":"World Neurosurg","first-page":"175","article-title":"Predictive factors of unfavorable events after Gamma Knife radiosurgery for vestibular schwannoma","volume":"107","author":"Kim JH","year":"2017","unstructured":"Kim JH, Jung HH, Chang JH, Chang JW, Park YG, Chang WS. Predictive factors of unfavorable events after Gamma Knife radiosurgery for vestibular schwannoma. 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Laryngoscope. 2019;129(5):1197\u20131205."},{"issue":"2","key":"b8","series-title":"J Neurooncol","first-page":"247","article-title":"Long term results of primary radiosurgery for vestibular schwannomas","volume":"145","author":"Johnson S","year":"2019","unstructured":"Johnson S, Kano H, Faramand A,  Long term results of primary radiosurgery for vestibular schwannomas. J Neurooncol. 2019;145(2):247\u2013255."},{"issue":"3","key":"b9","series-title":"Int J Radiat Oncol Biol Phys","first-page":"725","article-title":"Long-term outcomes of sporadic vestibular schwannomas treated with recent stereotactic radiosurgery techniques","volume":"108","author":"Hasegawa T","year":"2020","unstructured":"Hasegawa T, Kato T, Naito T,  Long-term outcomes of sporadic vestibular schwannomas treated with recent stereotactic radiosurgery techniques. Int J Radiat Oncol Biol Phys. 2020;108(3):725\u2013733."},{"issue":"6","key":"b10","series-title":"Neurosurgery","first-page":"E1084","article-title":"Treatment outcomes and dose rate effects following Gamma Knife stereotactic radiosurgery for vestibular schwannomas","volume":"85","author":"Smith DR","year":"2019","unstructured":"Smith DR, Saadatmand HJ, Wu CC,  Treatment outcomes and dose rate effects following Gamma Knife stereotactic radiosurgery for vestibular schwannomas. Neurosurgery. 2019;85(6):E1084\u2013E1094."},{"issue":"2","key":"b11","series-title":"Neuro Oncol","first-page":"545","article-title":"Dynamics of tumor evolution after Gamma Knife radiosurgery for sporadic vestibular schwannoma: defining volumetric patterns characterizing individual trajectory","volume":"27","author":"Balossier A","year":"2025","unstructured":"Balossier A, Olteanu M, Delsanti C,  Dynamics of tumor evolution after Gamma Knife radiosurgery for sporadic vestibular schwannoma: defining volumetric patterns characterizing individual trajectory. Neuro Oncol. 2025;27(2):545\u2013556."},{"issue":"5","key":"b12","series-title":"Otolaryngol Head Neck Surg","first-page":"803","article-title":"A new standardized format for reporting hearing outcome in clinical trials","volume":"147","author":"Gurgel RK","year":"2012","unstructured":"Gurgel RK, Jackler RK, Dobie RA, Popelka GR. A new standardized format for reporting hearing outcome in clinical trials. 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American Academy of Otolaryngology-Head and Neck Surgery Foundation, INC. Otolaryngol Head Neck Surg. 1995;113(3):179\u2013180."},{"issue":"2","key":"b15","series-title":"Otolaryngol Head Neck Surg","first-page":"146","article-title":"Facial nerve grading system","volume":"93","author":"House JW","year":"1985","unstructured":"House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146\u2013147."},{"issue":"3","key":"b16","series-title":"Otolaryngol Head Neck Surg","first-page":"967","article-title":"Associations of microvascular risk factors with sporadic vestibular schwannoma outcomes following stereotactic radiosurgery","volume":"172","author":"Dornhoffer JR","year":"2025","unstructured":"Dornhoffer JR, Babajanian EE, Khandalavala KR,  Associations of microvascular risk factors with sporadic vestibular schwannoma outcomes following stereotactic radiosurgery. 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