Helmy Mohamed, Liao Yujun, Zhang YiYin, He Kangmin
Department of Neurosurgery, Fudan University Huashan Hospital, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China.
Department of Nursing, Fudan University Huashan Hospital, Shanghai, China.
World Neurosurg. 2023 Oct;178:e345-e354. doi: 10.1016/j.wneu.2023.07.068. Epub 2023 Jul 20.
Cavernous sinus hemangiomas (CSHs) are infrequent benign neoplasms. This meta-analysis was conducted with the objective of examining the prognostic outcomes of surgical interventions and radiotherapy (RT) in patients diagnosed with CSHs.
A comprehensive literature search was performed across PubMed, Embase, and Web of Science databases, with traceability up to June 22, 2021. The evaluation of continuous variables was conducted by applying the weighted mean difference (WMD) and 95% confidence interval. A one-arm meta-analysis was used to scrutinize the tumor control rate, clinical improvement rate, recovery rates of abducens nerve palsy and visual disturbance, total resection rate, and the incidence rate of permanent nerve palsy post-treatment.
In total, 29 articles were incorporated into the meta-analysis. Post-RT for CSHs, a significant reduction in tumor volume was observed (WMD [95% confidence interval] = -17.16 [-21.52, -12.80] cm). The tumor control rate, clinical improvement rate, recovery rate of abducens nerve palsy, and the recovery rate of visual disturbance were 97.1% (92.9, 99.7), 91.9% (82.3, 98.5), 95.6% (83.2, 100.0), and 86.3% (65.0, 99.5), respectively. Following surgical treatment, the total resection rate, mean intraoperative blood loss, recovery rate of visual disturbance, incidence rate of permanent nerve palsy, and recovery rate of abducens nerve palsy were 73.2% (57.1, 86.9), 971.17 mL (584.07, 1358.27), 66.4% (32.4, 0.942), 16.0% (4.6, 31.1), and 70.6% (51.0, 87.7), respectively. Notably, the recovery rate of abducens nerve palsy post-RT was markedly higher than postsurgical treatment.
The results of this meta-analysis underscore that RT is an effective and safe treatment modality for CSHs. Furthermore, the prognostic outcomes of RT demonstrated superiority over surgical intervention.
海绵窦血管瘤（CSHs）是一种罕见的良性肿瘤。本荟萃分析旨在研究诊断为CSHs的患者手术干预和放疗（RT）的预后结果。
在PubMed、Embase和Web of Science数据库中进行全面的文献检索，追溯至2021年6月22日。通过应用加权平均差（WMD）和95%置信区间对连续变量进行评估。采用单臂荟萃分析来审查肿瘤控制率、临床改善率、展神经麻痹和视力障碍的恢复率、全切除率以及治疗后永久性神经麻痹的发生率。
总共29篇文章纳入了荟萃分析。CSHs放疗后，观察到肿瘤体积显著减小（WMD [95%置信区间]= -17.16 [-21.52, -12.80] cm）。肿瘤控制率、临床改善率、展神经麻痹恢复率和视力障碍恢复率分别为97.1%（92.9, 99.7）、91.9%（82.3, 98.5）、95.6%（83.2, 100.0）和86.3%（65.0, 99.5）。手术治疗后，全切除率、平均术中失血量、视力障碍恢复率、永久性神经麻痹发生率和展神经麻痹恢复率分别为73.2%（57.1, 86.9）、971.17 mL（584.07, 1358.27）、66.4%（32.4, 0.942）、16.0%（4.6, 31.1）和70.6%（51.0, 87.7）。值得注意的是，放疗后展神经麻痹的恢复率明显高于手术治疗后。
本荟萃分析结果强调，放疗是CSHs一种有效且安全的治疗方式。此外，放疗的预后结果显示出优于手术干预。
