Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e497-502. doi: 10.1016/j.ijrobp.2011.05.006. Epub 2011 Jun 22.
During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors.
To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was <25%. Bias was assessed using the Egger funnel plot test.
Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control.
The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.
在过去的二十年中，放射外科已成为治疗颈静脉球体瘤的一种很有前途的方法。本研究对可用于治疗颈静脉球体瘤的放射外科管理的现有已发表数据进行了系统回顾和荟萃分析。
为了确定合格的研究，在主要的科学出版物数据库中对所有接受放射外科治疗的颈静脉球体瘤进行了系统搜索。该数据搜索产生了 19 项研究，这些研究被纳入荟萃分析。从 335 例颈静脉球体瘤患者中提取数据。当 Cochrane 统计量无统计学意义且研究之间的不一致性<25%时，从数据中计算固定效应合并比例。使用 Egger 漏斗图检验评估偏倚。
在所有研究中，97%的患者肿瘤得到控制，95%的患者临床得到控制。有 8 项研究报告了>36 个月的平均或中位随访时间。在这些研究中，95%的患者临床控制，96%的患者肿瘤控制。伽玛刀、线性加速器和 CyberKnife 技术的肿瘤和临床控制率均很高。
本研究报告了颈静脉球体瘤放射外科治疗的荟萃分析结果。由于其高效性，我们建议考虑放射外科作为颈静脉球体瘤的主要治疗方法。
