Abstract
New details about the role of proinflammatory pathways in the molecular pathogenesis of vestibular schwannoma have inspired the researchers to experiment aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of the tumor. Encouraging evidences have been reported in clinical studies. However, a double-blind, placebo-controlled, randomized trial is still missing and needed to ultimately address the efficacy of aspirin as a cytostatic on vestibular schwannoma and its correct posology. Second and even more ambitious target would be application of aspirin as a cytostatic for secondary prevention of tumor growth. In the personal experience, nine patients have undergone subtotal tumor resection and have been prescribed postoperative aspirin off-label with the purpose of avoiding recurrences. The maximum follow-up period has been 47 months, and only the first patient needed reoperation due to tumor regrowth; the remaining eight patients are being followed up and show stable tumors.
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References
Van Gompel JJ, Agazzi S, Carlson ML, Adewumi DA, Hadjipanayis CG, Uhm JH, et al. Congress of Neurological Surgeons systematic review and evidence-based guidelines on emerging therapies for the treatment of patients with vestibular schwannomas. Neurosurgery. 2018;82(2):E52–E4.
Hong B, Krusche CA, Schwabe K, Friedrich S, Klein R, Krauss JK, et al. Cyclooxygenase-2 supports tumor proliferation in vestibular schwannomas. Neurosurgery. 2011;68(4):1112–7.
Dilwali S, Kao SY, Fujita T, Landegger LD, Stankovic KM. Nonsteroidal anti-inflammatory medications are cytostatic against human vestibular schwannomas. Transl Res. 2015;166(1):1–11.
Kandathil CK, Dilwali S, Wu CC, Ibrahimov M, McKenna MJ, Lee H, et al. Aspirin intake correlates with halted growth of sporadic vestibular schwannoma in vivo. Otol Neurotol. 2014;35(2):353–7.
Kandathil CK, Cunnane ME, McKenna MJ, Curtin HD, Stankovic KM. Correlation between aspirin intake and reduced growth of human vestibular schwannoma: volumetric analysis. Otol Neurotol. 2016;37(9):1428–34.
Hunter JB, O’Connell BP, Wanna GB, Bennett ML, Rivas A, Thompson RC, et al. Vestibular schwannoma growth with aspirin and other nonsteroidal anti-inflammatory drugs. Otol Neurotol. 2017;38(8):1158–64.
MacKeith S, Wasson J, Baker C, Guilfoyle M, John D, Donnelly N, et al. Aspirin does not prevent growth of vestibular schwannomas: a case-control study. Laryngoscope. 2018;128(9):2139–44.
Bannwarth B, Netter P, Pourel J, Royer RJ, Gaucher A. Clinical pharmacokinetics of nonsteroidal anti-inflammatory drugs in the cerebrospinal fluid. Biomed Pharmacother. 1989;43(2):121–6.
Bart J, Groen HJ, Hendrikse NH, van der Graaf WT, Vaalburg W, de Vries EG. The blood-brain barrier and oncology: new insights into function and modulation. Cancer Treat Rev. 2000;26(6):449–62.
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Campione, A., Cacciotti, G., Roperto, R., Giacobbo Scavo, C., Mastronardi, L. (2019). Aspirin Administration for Control of Tumor Millimetric Residual. In: Mastronardi, L., Fukushima, T., Campione, A. (eds) Advances in Vestibular Schwannoma Microneurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-03167-1_17
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DOI: https://doi.org/10.1007/978-3-030-03167-1_17
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