Bhavya Pahwa, Sanah Mahajan, Nishtha Pahwa, Nicholas Panico, Jason P Sheehan
{"title":"线性回归模型预测接受伽玛刀放射治疗复发和残留颅咽管瘤患者的生存率和并发症发生率：一项对743例肿瘤的meta分析。","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":"{\"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}","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
摘要
目的：颅咽管瘤是临床上侵袭性的良性肿瘤，由于其高复发率和术后并发症，对临床医生提出了特殊的挑战。单纯的手术干预带来了许多挑战，因此，使用放射辅助治疗方式已经变得普遍。本研究旨在评估伽玛刀放射手术（GKRS）治疗复发和残留颅咽管瘤的有效性，并确定可预测生存率和并发症发生率的因素。方法：PubMed和Cochrane图书馆从成立到2024年9月进行筛选。建立固定效应模型（I2 2 bb0 50%），研究总生存率和并发症发生率。建立线性回归模型以确定影响预后的因素，并用f检验检验模型的显著性。结果：荟萃分析包括来自9个选定研究的743个肿瘤。估计3年、5年和10年OS率分别为96%、93%和85%，估计3年、5年和10年PFS率分别为83%、68%和45%。估计视力（VD）和内分泌功能障碍（ED）率分别为5%和4%。中位边际剂量≤13 Gy是3年OS的独立预测因子（β= 1.95, p = 0.02），而女性患者（β=-0.52, p = 0.023）、年龄（β=-0.36, p = 0.04）和中位边际剂量≤13 Gy （β= 2.55, p = 0.001）是5年OS的显著预测因子。f检验显示，3年和5年OS率模型具有显著性，R2分别为0.99 （p = 0.03）和0.98 （p = 0.008）。年龄是VD的单一显著预测因子（β=-0.80, p = 0.032），而肿瘤体积（β= 0.61, p = 0.035）和中位边际剂量≤13 Gy （β=-1.17, p = 0.039）是ed的显著预测因子。结论：GKRS是复发和残留颅咽管瘤的有效治疗方式，在安全剂量≤13 Gy的情况下，其生存率与其他治疗方式相当，并发症发生率显著降低。
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.
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.
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