Radiosurgery versus radiation therapy for long term local control rate of craniopharyngioma: a meta-analysis.

INTRODUCTION

Craniopharyngiomas are challenging benign tumors arising from Rathke's pouch remnants, often requiring multidisciplinary management due to their proximity to critical neurovascular structures. This meta-analysis systematically compares conventional radiation therapy (RT) and stereotactic radiosurgery (RS) in treating residual or recurrent craniopharyngiomas.

METHOD

A comprehensive literature search identified 44 studies, including 46 reports, meeting inclusion criteria such as progression-free survival (PFS) and post-radiotherapy complications. Data extraction followed PRISMA guidelines.

RESULTS

The pooled 5-year PFS favored RT (0.843; 95% CI: 0.767-0.898) over RS (0.680; 95% CI: 0.631-0.727), as did 10-year PFS (RT: 0.813; 95% CI: 0.683-0.888; RS: 0.553; 95% CI: 0.470-0.634). RT demonstrated mitigating tumor recurrence risks. Visual and hormonal complication rates between the modalities were comparable (visual: ~4%; hormonal: ~6%).

CONCLUSION

RT consistently achieved superior long-term PFS compared to RS, reaffirming its role as the standard for adjuvant therapy in craniopharyngiomas. This analysis highlights the need for tailored treatment strategies balancing efficacy and safety, ultimately enhancing patient outcomes.