Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
J Neurooncol. 2023 Jan;161(2):215-224. doi: 10.1007/s11060-022-04112-6. Epub 2022 Aug 17.
To compare the efficacy, outcomes, and complications of single session (SS-SRS) and multisession (MS-SRS) stereotactic radiosurgery in the treatment of intracranial meningiomas.
Relevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane. A systematic review and meta-analysis of treatment protocols and outcomes were conducted. After the selection process, 20 articles describing 1483 cases were included.
A total of 1303 patients who underwent SS-SRS and 180 patients who underwent MS-SRS for the management of their intracranial meningioma were reported in the included studies. SS-SRS and MS-SRS had comparable one-year (SS-SRS: 98% vs. MS-SRS: 100%, p > 0.99) and five-year (SS-SRS: 94% vs. MS-SRS: 93%, p = 0.71) tumor control rates. The groups also had comparable tumor volume reduction/tumor regression rates (SS-SRS: 44% vs. MS-SRS: 25%, p = 0.25), tumor volume stability rates (SS-SRS: 51% vs. MS-SRS: 75%, p = 0.12), and tumor progression rates (SS-SRS: 4% vs. MS-SRS: 4%, p = 0.89). SS-SRS and MS-SRS yielded similar complication rates (10.4% vs. 11.4%, p = 0.68) and comparable functional improvement rates (MS-SRS: 44% vs. SS-SRS: 36%, p = 0.57). However, MS-SRS was used for significantly larger tumor volumes (MS-SRS: 23.8 cm vs. SS-SRS: 6.1 cm, p = 0.02).
SS-SRS and MS-SRS resulted in comparable tumor control, tumor volumetric change, and functional outcomes despite significant biases in selecting patients for SS- or MS-SRS.
比较单次立体定向放射外科（SS-SRS）和多次立体定向放射外科（MS-SRS）治疗颅内脑膜瘤的疗效、结果和并发症。
从 PubMed、Scopus、Web of Science 和 Cochrane 检索相关文章。对治疗方案和结果进行系统评价和荟萃分析。经过筛选过程，共纳入 20 篇描述 1483 例患者的文章。
纳入的研究中，共有 1303 例患者接受 SS-SRS 治疗，180 例患者接受 MS-SRS 治疗颅内脑膜瘤。SS-SRS 和 MS-SRS 的一年肿瘤控制率（SS-SRS：98% vs. MS-SRS：100%，p＞0.99）和五年肿瘤控制率（SS-SRS：94% vs. MS-SRS：93%，p=0.71）相似。两组肿瘤体积缩小/肿瘤消退率（SS-SRS：44% vs. MS-SRS：25%，p=0.25）、肿瘤体积稳定率（SS-SRS：51% vs. MS-SRS：75%，p=0.12）和肿瘤进展率（SS-SRS：4% vs. MS-SRS：4%，p=0.89）也相似。SS-SRS 和 MS-SRS 的并发症发生率（10.4% vs. 11.4%，p=0.68）和功能改善率（MS-SRS：44% vs. SS-SRS：36%，p=0.57）相似。然而，MS-SRS 用于治疗的肿瘤体积明显更大（MS-SRS：23.8cm vs. SS-SRS：6.1cm，p=0.02）。
尽管在选择 SS-SRS 或 MS-SRS 患者方面存在显著偏倚，但 SS-SRS 和 MS-SRS 治疗结果相似，包括肿瘤控制、肿瘤体积变化和功能结局。
