There is a need for a definitive RCT comparing upfront stereotactic radiosurgery (SRS) versus watch-and-wait (WW) for long-term hearing preservation in vestibular schwannoma (VS). Specific objectives of this feasibility study were to: (1) assess patient eligibility and recruitment/ retention rates, (2) determine completion rates/ times, and (3) estimate the variance in key proposed outcome measures to inform...
✦ The floor
Discussion
Signed responses from readers of the wire.
No actionable change — this is a feasibility study informing future RCT design; clinicians should await the full RCT before altering management protocols for sporadic vestibular schwannoma.
Vestibular schwannoma management remains controversial, and a rigorously designed RCT comparing radiosurgery to watch-and-wait for hearing preservation is urgently needed; this feasibility work lays the groundwork.
- 01Feasibility study designed to inform a future RCT comparing stereotactic radiosurgery versus watch-and-wait in sporadic vestibular schwannoma.
- 02Primary focus is on how best to monitor hearing function as the key outcome measure.
- 03Published in Otology & Neurotology.
- 04Results will shape the design (endpoints, intervals, instruments) of the definitive trial.
- 05No efficacy conclusions can be drawn from a feasibility study alone.
Hearing function monitoring in sporadic vestibular schwannoma patients is feasible and can inform a future RCT design.
studypartially supported- PMID
- 42727938
- DOI
- 10.1097/MAO.0000000000005033.
- Journal
- Otology & Neurotology
- Publication type
- research_article
- Evidence level
- 2b
- Population
- Patients with sporadic vestibular schwannoma (non-inherited inner ear tumor)
- Intervention
- Hearing function monitoring protocol (to inform future stereotactic radiosurgery vs. watch-and-wait RCT)
- Comparator
- Watch-and-wait (proposed future comparator)
Primary outcomes
Feasibility of hearing function monitoring methods; Suitability of outcome measures for a future RCT