Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Crit Rev Oncol Hematol. 2021 Dec;168:103508. doi: 10.1016/j.critrevonc.2021.103508. Epub 2021 Oct 19.
The current standard of care for surgically inaccessible low-grade brainstem gliomas (BS-LLGs) is external-beam radiotherapy (RT). Developments toward more innovative conformal techniques have focused on decreasing morbidity, by limiting radiation to surrounding tissues. Among these Gamma Knife radiosurgery (SRS-GK) has recently gained an increasingly important role in the treatment of these tumors. Although SRS-GK has not yet been compared with conventional RT in patients harboring focal BS-LGGs, clinical practice has been deeply influenced by trials performed on other tumors. This is the first meta-analysis on the topic, systematically reviewing the most relevant available evidence, comparing RT and SRS-GK as primary treatments of BS-LGGs, focusing on survival, clinical outcome, oncological control, and complications. Predictive factors have been systematically evaluated and analyzed according to statistical significance and clinical relevance.
目前，手术无法触及的低级脑干神经胶质瘤（BS-LLGs）的标准治疗方法是外照射放疗（RT）。为了采用更具创新性的适形技术，研究重点是通过将辐射限制在周围组织来降低发病率。在这些技术中，伽玛刀放射外科手术（SRS-GK）最近在治疗这些肿瘤方面发挥了越来越重要的作用。尽管 SRS-GK 尚未在患有局灶性 BS-LGG 的患者中与常规 RT 进行比较，但临床实践深受针对其他肿瘤进行的试验的影响。这是该主题的第一项荟萃分析，系统地回顾了最相关的现有证据，比较了 RT 和 SRS-GK 作为 BS-LGG 的主要治疗方法，重点关注生存率、临床结果、肿瘤控制和并发症。根据统计学意义和临床相关性，系统地评估和分析了预测因素。
