Department of Neurosurgery, Unit of Radiotherapy, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italia.
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Neurosurgery. 2020 Oct 15;87(5):879-890. doi: 10.1093/neuros/nyaa169.
Stereotactic radiosurgery (SRS) for benign intracranial meningiomas is an established treatment.
To summarize the literature and provide evidence-based practice guidelines on behalf of the International Stereotactic Radiosurgery Society (ISRS).
Articles in English specific to SRS for benign intracranial meningioma, published from January 1964 to April 2018, were systematically reviewed. Three electronic databases, PubMed, EMBASE, and the Cochrane Central Register, were searched.
Out of the 2844 studies identified, 305 had a full text evaluation and 27 studies met the criteria to be included in this analysis. All but one were retrospective studies. The 10-yr local control (LC) rate ranged from 71% to 100%. The 10-yr progression-free-survival rate ranged from 55% to 97%. The prescription dose ranged typically between 12 and 15 Gy, delivered in a single fraction. Toxicity rate was generally low.
The current literature supporting SRS for benign intracranial meningioma lacks level I and II evidence. However, when summarizing the large number of level III studies, it is clear that SRS can be recommended as an effective evidence-based treatment option (recommendation level II) for grade 1 meningioma.
立体定向放射外科（SRS）治疗良性颅内脑膜瘤已得到广泛认可。
代表国际立体定向放射外科协会（ISRS）对相关文献进行总结，为良性颅内脑膜瘤的 SRS 治疗提供循证实践指南。
系统性检索了 1964 年 1 月至 2018 年 4 月发表的关于 SRS 治疗良性颅内脑膜瘤的英文文献，检索范围涵盖 3 个电子数据库（PubMed、EMBASE 和 Cochrane 中央注册库）。
在总共检索到的 2844 篇文献中，有 305 篇文献全文符合纳入标准，27 篇文献最终被纳入本分析。除 1 篇外，其余均为回顾性研究。10 年局部控制率为 71%至 100%，无进展生存率为 55%至 97%。处方剂量通常为 12 至 15Gy，单次分割。总体而言，毒性发生率较低。
目前关于 SRS 治疗良性颅内脑膜瘤的文献主要为 III 级证据，缺乏 I 级和 II 级证据。但在对大量 III 级研究进行总结后，我们可以明确 SRS 是 1 级脑膜瘤的一种有效治疗选择（推荐级别 II）。
