Linear regression models predict survival and complication rates in patients undergoing gamma knife radiosurgery for recurrent and residual craniopharyngiomas: a meta-analysis of 743 tumors.
Bhavya Pahwa, Sanah Mahajan, Nishtha Pahwa, Nicholas Panico, Jason P Sheehan
{"title":"Linear regression models predict survival and complication rates in patients undergoing gamma knife radiosurgery for recurrent and residual craniopharyngiomas: a meta-analysis of 743 tumors.","authors":"Bhavya Pahwa, Sanah Mahajan, Nishtha Pahwa, Nicholas Panico, Jason P Sheehan","doi":"10.1007/s11060-025-05196-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Craniopharyngiomas are clinically aggressive benign tumors that present a special challenge for clinicians due to high recurrence rates and post operative compilations. Surgical intervention alone poses many challenges and therefore, the use of radiotherapeutic adjuvant modalities has become common. This study aims to evaluate the effectiveness of gamma knife radiosurgery (GKRS) in the management of recurrent and residual craniopharyngiomas and identify the factors that could predict survival and complication rates.</p><p><strong>Methods: </strong>PubMed and Cochrane library were screened from inception until September 2024. Fixed effect models (I<sup>2</sup> < 50%) and Random effects models (I<sup>2</sup> > 50%) were created to study the pooled survival rates and complication rates. Linear Regression models were generated to identify the prognostic factors and F-test was used to check the significance of the models.</p><p><strong>Results: </strong>The meta-analysis included 743 tumors from nine selected studies. Estimated 3, 5 and 10 year OS rates were 96%, 93% and 85% respectively and estimated 3, 5 and 10 year PFS rates were 83%, 68% and 45% respectively. Estimated visual (VD) and endocrinological dysfunction (ED) rates were 5% and 4% respectively. Median marginal dose ≤ 13 Gy was the independent predictor of 3 year OS (β = 1.95, p = 0.02), while female patients (β=-0.52, p = 0.023), age (β=-0.36, p = 0.04) and median marginal dose ≤ 13 Gy (β = 2.55, p = 0.001) were found to be significant predictors of 5 year OS. F-test revealed that the models generated for 3 year and 5 year OS rates were significant with an excellent R<sup>2</sup> values of 0.99 (p = 0.03) and 0.98 (p = 0.008) respectively. Age was the single significant predictor of VD (β=-0.80, p = 0.032) while tumor volume (β = 0.61, p = 0.035) and median marginal dose ≤ 13 Gy (β=-1.17, p = 0.039) were significant predictors of ED.</p><p><strong>Conclusions: </strong>GKRS is an effective treatment modality for recurrent and residual craniopharyngiomas, providing comparable to improved survival rates to other modalities and significantly lower complication rates with a safe dose of ≤ 13 Gy.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"933-942"},"PeriodicalIF":3.1000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-025-05196-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Craniopharyngiomas are clinically aggressive benign tumors that present a special challenge for clinicians due to high recurrence rates and post operative compilations. Surgical intervention alone poses many challenges and therefore, the use of radiotherapeutic adjuvant modalities has become common. This study aims to evaluate the effectiveness of gamma knife radiosurgery (GKRS) in the management of recurrent and residual craniopharyngiomas and identify the factors that could predict survival and complication rates.
Methods: PubMed and Cochrane library were screened from inception until September 2024. Fixed effect models (I2 < 50%) and Random effects models (I2 > 50%) were created to study the pooled survival rates and complication rates. Linear Regression models were generated to identify the prognostic factors and F-test was used to check the significance of the models.
Results: The meta-analysis included 743 tumors from nine selected studies. Estimated 3, 5 and 10 year OS rates were 96%, 93% and 85% respectively and estimated 3, 5 and 10 year PFS rates were 83%, 68% and 45% respectively. Estimated visual (VD) and endocrinological dysfunction (ED) rates were 5% and 4% respectively. Median marginal dose ≤ 13 Gy was the independent predictor of 3 year OS (β = 1.95, p = 0.02), while female patients (β=-0.52, p = 0.023), age (β=-0.36, p = 0.04) and median marginal dose ≤ 13 Gy (β = 2.55, p = 0.001) were found to be significant predictors of 5 year OS. F-test revealed that the models generated for 3 year and 5 year OS rates were significant with an excellent R2 values of 0.99 (p = 0.03) and 0.98 (p = 0.008) respectively. Age was the single significant predictor of VD (β=-0.80, p = 0.032) while tumor volume (β = 0.61, p = 0.035) and median marginal dose ≤ 13 Gy (β=-1.17, p = 0.039) were significant predictors of ED.
Conclusions: GKRS is an effective treatment modality for recurrent and residual craniopharyngiomas, providing comparable to improved survival rates to other modalities and significantly lower complication rates with a safe dose of ≤ 13 Gy.
期刊介绍：
The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
