Stereotactic radiosurgery for intraventricular meningioma: a systematic review and meta-analysis.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-07-09 DOI:10.1007/s00701-024-06185-w

Alireza Soltani Khaboushan, Mohammad Amin Dabbagh Ohadi, Hanieh Amani, Mohammad Dashtkoohi, Arad Iranmehr, Jason P Sheehan

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Abstract

Background: Intraventricular meningioma (IVM) is a rare subtype of intracranial meningioma, accounting for 9.8 to 14% of all intraventricular tumors. Currently, there is no clear consensus on which patients with IVM should receive conservative treatment, surgery, or stereotactic radiosurgery (SRS). This research aims to analyze the outcomes, including survival and recurrence rates of patients who undergo SRS for IVM as a primary or adjuvant treatment.

Methods: A systematic search was conducted in Scopus, Web of Science, PubMed, and Embase till June 5th 2023. Screening and data extraction were performed by two independent authors. Random-effect meta-analysis was performed to determine the tumor control proportion of IVM cases treated with SRS. Individual patient data (IPD) meta-analysis was performed for the progression-free survival (PFS) of the patients in the follow-up time. All analyses were performed using the R programming language.

Results: Out of the overall 132 records, 14 were included in our study, of which only 7 had enough data for the meta-analysis. The tumor control proportion was 0.92 (95% CI, 0.69-0.98) in patients who underwent SRS for primary IVM. The overall tumor control in both primary and adjuvant cases was 0.87 (95% CI, 0.34-0.99). the heterogeneity was not significant in both meta-analyses (P = 0.73 and P = 0.92, respectively). Post-SRS perifocal edema occurred in 16 out of 71 cases (0.16; 95% CI, 0.03-0.56), with no significant heterogeneity (P = 0.32). IPD meta-analysis showed a PFS of 94.70% in a 2-year follow-up. Log-rank test showed better PFS in primary SRS compared to adjuvant SRS (P < 0.01).

Conclusions: According to this study, patients with IVM can achieve high rates of tumor control with a low risk of complications when treated with SRS, regardless of whether they have received prior treatment. Although SRS could be a promising first-line treatment option for asymptomatic IVM, its efficacy in symptomatic patients and its comparison with resection require further investigation.

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立体定向放射外科治疗脑室内脑膜瘤：系统综述和荟萃分析。

背景：脑室内脑膜瘤（IVM）是颅内脑膜瘤的一种罕见亚型，占脑室内肿瘤总数的9.8%至14%。目前，对于哪些 IVM 患者应该接受保守治疗、手术或立体定向放射外科手术（SRS），还没有明确的共识。本研究旨在分析 IVM 患者接受 SRS 作为主要或辅助治疗的结果，包括生存率和复发率：截至 2023 年 6 月 5 日，在 Scopus、Web of Science、PubMed 和 Embase 中进行了系统检索。筛选和数据提取由两位独立作者完成。随机效应荟萃分析确定了接受SRS治疗的IVM病例的肿瘤控制比例。对随访期间患者的无进展生存期（PFS）进行了患者个体数据（IPD）荟萃分析。所有分析均使用R编程语言进行：在132份记录中，有14份被纳入我们的研究，其中只有7份有足够的数据进行荟萃分析。接受 SRS 治疗的原发性 IVM 患者的肿瘤控制率为 0.92（95% CI，0.69-0.98）。两项荟萃分析的异质性均不显著（P = 0.73 和 P = 0.92）。71 例病例中有 16 例（0.16；95% CI，0.03-0.56）出现 SRS 后病灶周围水肿，异质性不显著（P = 0.32）。IPD荟萃分析显示，2年随访的PFS为94.70%。对数秩检验显示，与辅助SRS相比，原发性SRS的PFS更好（P 结论：原发性SRS的PFS比辅助SRS的PFS更高：根据这项研究，IVM 患者在接受 SRS 治疗时，无论之前是否接受过治疗，都能获得较高的肿瘤控制率，且并发症风险较低。虽然SRS可能是无症状IVM的一线治疗方案，但其对有症状患者的疗效以及与切除术的比较仍需进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.