Risk analysis of radiosurgery for vestibular schwannoma: Systematic review and comparative study of 10-year outcomes
Bibliographic record
Abstract
Background: Determine the benefit of stereotactic radiosurgery (SRS) compared to no treatment for sporadic vestibular schwannoma (VS) by calculating epidemiologic risk using 10-year data; apply the analysis to VS that have demonstrated linear growth. Methods: PubMed, Google Scholar, Web of Science, and Cochrane Library are systematically reviewed for VS tumor control 10 years after SRS and compared to a historical cohort of untreated VS (primary risk analysis). Subgroups of VS limited by size and observed growth are compared to the untreated cohort (secondary analysis). Results: Twenty-four studies of 4079 SRS-treated VS exhibited tumor control in 90.93% (87.0%-100%; SD 4.1%), while 1959 untreated VS exhibited control in 65.24%. SRS reduces the absolute risk (ARR) of tumor progression by 25.7% compared to no treatment. The number needed to treat (NNT) is 4 (3.892, 95% CI: 3.619-4.210). Subgroup analyses of (1) VS with definite linear growth before SRS result in a similar ARR of 29.4% and NNT 4 (3.395, 95% CI: 2.966-3.968), and (2) Koos 1 VS result in lower ARR 18.31% and higher NNT 6 (5.209; 95% CI: 4.018-7.401). Conclusions: This "best-available" case-control study of 10-year data reveals that ARR and NNT are similar for VS with and without definite pretreatment linear growth. These comparisons may be applied to CPA diameters less than 2 cm. Results for Koos 1 tumors are different. This analysis quantifies the therapeutic benefit of SRS by comparative risk analysis. The level of evidence on this topic is low.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".