Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
Neurosurg Rev. 2024 Jan 24;47(1):64. doi: 10.1007/s10143-024-02301-7.
Central neurocytomas (CN) are rare tumors within the central nervous system. Originating from the septum pellucidum and subependymal cells, they are typically found in the third and lateral ventricles. For this reason, they may lead to hydrocephalus and increased intracranial pressure. CNs are generally benign lesions that exhibit locally aggressive behavior and a high recurrence rate. Complete surgical resection is the preferred treatment; however, due to their anatomical location, this is often not feasible. Based on these findings, Gamma Knife radiosurgery (GKRS) has been introduced for managing both residual and recurrent tumors and as an initial therapy in selected cases. This study aimed to systematically review the available knowledge regarding GKRS for CN. A systematic investigation of the scientific literature was undertaken through an exhaustive search across prominent databases, including PubMed, Web of Science, and Google Scholar, by employing precise MeSH terms such as "Central neurocytoma," "Radiosurgery," "Gamma Knife," and "Stereotactic Radiosurgery." A comprehensive quantitative systematic review and meta-analysis were meticulously conducted, focusing on cases of CN treated with GKRS for a thorough evaluation of outcomes and efficacy. Seventeen articles, including 289 patients, met the inclusion criteria. Random effects meta-analysis estimates for disease control and local tumor control were 90% (95% CI 87-93%; I2 = 0%, p < 0.74) and 94% (95% CI 92-97%; I2 = 0%, p < 0.98), respectively. When considering only studies with at least 5 years of follow-up, progression-free survival was 89% (95% CI 85-94%; I2 = 0.03%, p < 0.74). The mean clinical control rate was 96%. This systematic review and meta-analysis confirmed the safety and efficacy of GKRS in managing CN.
中枢神经细胞瘤(CN)是一种罕见的中枢神经系统肿瘤。起源于透明隔和室管膜下细胞,它们通常位于第三和侧脑室。因此,它们可能导致脑积水和颅内压增高。CN 一般为良性病变,表现出局部侵袭性和高复发率。完全手术切除是首选治疗方法;然而,由于其解剖位置,这往往是不可行的。基于这些发现,伽玛刀放射外科(GKRS)已被引入用于治疗残余和复发性肿瘤,并在选定病例中作为初始治疗。本研究旨在系统回顾 GKRS 治疗 CN 的现有知识。通过在包括 PubMed、Web of Science 和 Google Scholar 在内的知名数据库中进行全面搜索,采用精确的 MeSH 术语,如“中枢神经细胞瘤”、“放射外科”、“伽玛刀”和“立体定向放射外科”,对科学文献进行了系统调查。对接受 GKRS 治疗的 CN 病例进行了全面的定量系统评价和荟萃分析,以彻底评估结果和疗效。符合纳入标准的有 17 篇文章,共 289 例患者。疾病控制和局部肿瘤控制的随机效应荟萃分析估计值分别为 90%(95%CI 87-93%;I2=0%,p<0.74)和 94%(95%CI 92-97%;I2=0%,p<0.98)。当仅考虑至少 5 年随访的研究时,无进展生存率为 89%(95%CI 85-94%;I2=0.03%,p<0.74)。平均临床控制率为 96%。本系统评价和荟萃分析证实了 GKRS 治疗 CN 的安全性和有效性。