Palavani Lucca B, Semione Gabriel, de Oliveira Almeida Gustavo, Lepine Henrique L, Borges Pedro, Nogueira Bernardo Vieira, Lúcia Gisele, Ferreira Márcio Yuri, Pereira Anna, Batista da Hora David Abraham, de Jesus Leone Pereira Matheus, Torregrossa Fabio, Nigris Vasconcellos Fernando De, Bertani Raphael, Bastianon Raphael, Benjamin Carolina, Formentin Cleiton
Department of Medicine, Max Planck University Center, Indaiatuba, SP, Brazil.
Department of Medicine, University of West of Santa Catarina, Joaçaba, SC, Brazil.
J Clin Neurosci. 2025 Feb;132:110977. doi: 10.1016/j.jocn.2024.110977. Epub 2024 Dec 11.
Ependymomas account for 6% to 10% of childhood central nervous system tumors. This study aimed to evaluate the safety and efficacy of proton radiotherapy in intracranial ependymoma patients.
We performed a systematic review and single-arm meta-analysis. We searched Medline, Embase, Cochrane, and Web of Science for eligible trials. Random-effects model was used to calculate the risk ratios (RRs), with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3.
Ten cohorts comprising 908 patients with ependymoma were included. The patient population had an average age of 3.5 years, and 53.4 % were male. In terms of proportion, nine outcomes were analyzed: 3-year Progression-Free Survival (PFS; Proportion = 0.63; 95 % CI [0.40-0.87]; I2 = 95 %), 5-year Local Control (LC; Proportion = 0.79; 95 % CI [0.69-0.90]; I2 = 85 %), 5-year Event-Free Survival (EFS; Proportion = 0.65; 95 % CI [0.52-0.78]; I2 = 95 %), 5-year Overall Survival (OS; Proportion = 0.83; 95 % CI [0.77-0.90]; I2 = 82 %), 2-year OS (Proportion = 0.91; 95 % CI [0.88-0.94]; I2 = 0 %), 3-year OS (Proportion = 0.92; 95 % CI [0.89;0.95]; I2 = 43 %). Additionally, neurological (Proportion = 0.17; 95 % CI [0.07-0.27]; I2 = 97 %), dermatological (Proportion = 0.20; 95 % CI [0.00-0.44]; I2 = 82 %), and brainstem complications (Proportion = 0.03; 95 % CI [0.01-0.04]; I2 = 31 %) were investigated.
While proton radiotherapy appears safe and effective based on current data, these results should be approached cautiously, as broad confidence intervals in some adverse event rates suggest variability in outcomes.
室管膜瘤占儿童中枢神经系统肿瘤的6%至10%。本研究旨在评估质子放疗在颅内室管膜瘤患者中的安全性和有效性。
我们进行了一项系统评价和单臂荟萃分析。我们在Medline、Embase、Cochrane和Web of Science中检索符合条件的试验。采用随机效应模型计算风险比（RRs），并给出95%置信区间（CIs）。使用RStudio 4.2.3版本进行统计分析。
纳入了10个队列，共908例室管膜瘤患者。患者群体的平均年龄为3.5岁，53.4%为男性。在比例方面，分析了9个结局：3年无进展生存期（PFS；比例=0.63；95% CI [0.40 - 0.87]；I² = 95%），5年局部控制率（LC；比例=0.79；95% CI [0.69 - 0.90]；I² = 85%），5年无事件生存期（EFS；比例=0.65；95% CI [0.52 - 0.78]；I² = 95%），5年总生存期（OS；比例=0.83；95% CI [0.77 - 0.90]；I² = 82%），2年总生存期（比例=0.91；95% CI [0.88 - 0.94]；I² = 0%），3年总生存期（比例=0.92；95% CI [0.89 - 0.95]；I² = 43%）。此外，还调查了神经方面（比例=0.17；95% CI [0.07 - 0.27]；I² = 97%）、皮肤方面（比例=0.20；95% CI [0.00 - 0.44]；I² = 82%）和脑干并发症（比例=0.03；95% CI [0.01 - 0.04]；I² = 31%）。
基于目前的数据，质子放疗似乎是安全有效的，但这些结果应谨慎对待，因为一些不良事件发生率的宽泛置信区间表明结局存在变异性。
