伽玛刀立体定向放射外科治疗2型神经纤维瘤病（NF2）相关脑膜瘤；一项系统评价和荟萃分析。

Gamma knife stereotactic radiosurgery for neurofibromatosis 2 (NF2)-associated meningiomas; a systematic review and meta-analysis.

作者信息

Habibi Mohammad Amin, Mirjani Mohammad Sina, Ahmadvand Muhammad Hussain, Delbari Pouria, Alasti Omid, Akbari Javar Mohammad Taha, Askari Yazdian Fatemeh, Hamidi Rad Romina, Dinpazhouh Ali, Mehmandoost Mahdi, Tos Salem M, Hajikarimloo Bardia, Bahri Amirmohammad, Aghaei Fateme, Mehrizi Mohammad Ali Abouei

机构信息

Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Student Research Committee, Qom University of Medical Sciences, Qom, Iran.

出版信息

Acta Neurochir (Wien). 2025 Feb 5;167(1):35. doi: 10.1007/s00701-025-06436-4.

DOI:10.1007/s00701-025-06436-4

PMID:39907804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11799078/

Abstract

BACKGROUND

Neurofibromatosis type 2 (NF2)-related schwannomatosis is a rare genetic disorder associated with meningiomas. Stereotactic radiosurgery (SRS) has emerged as a potential non-invasive method. This study aims to synthesize the available evidence on using SRS to treat these tumors.

METHODS

PubMed/Medline, Embase, Scopus, and Web of Science were searched until March 21, 2024. This study was prepared by adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).

RESULTS

Four studies were included comprising 101 patients with NF2-associated meningiomas treated with SRS. All included studies used gamma knife stereotactic radiosurgery (GKRS) as treatment modality. Overall survival rates remained high (100%) up to 3 years post-treatment, with slight declines at five years of 98% (95% CI: 0.95-1.01) and ten years of 68% (95% CI: 0.48-0.87). Progression-free survival rates were similarly favorable, with 95% (95% CI: 89-101%) at three years, 93% (95% CI: 86-99%) at five years, and 81% (95% CI: 51-111%) at ten years. The pooled radiation necrosis rate was 5% (95% CI: 3-7%), while the overall radiation toxicity rate was 16% (95% CI: 11-21%). Local tumor control rates were high at six months, and at 12 months, they were 100% (95% CI: 1.00-1.00).

CONCLUSION

GKRS demonstrates high efficacy and a favorable safety profile for NF2-associated meningiomas, offering a valuable treatment option for this challenging patient population.

摘要

背景

2型神经纤维瘤病（NF2）相关的神经鞘瘤病是一种与脑膜瘤相关的罕见遗传性疾病。立体定向放射外科（SRS）已成为一种潜在的非侵入性治疗方法。本研究旨在综合关于使用SRS治疗这些肿瘤的现有证据。

方法

检索了PubMed/Medline、Embase、Scopus和Web of Science直至2024年3月21日。本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）进行撰写。

结果

纳入了四项研究，共101例接受SRS治疗的NF2相关脑膜瘤患者。所有纳入研究均采用伽玛刀立体定向放射外科（GKRS）作为治疗方式。治疗后3年内总生存率保持较高水平（100%），5年时略有下降，为98%（95%CI：0.95 - 1.01），10年时为68%（95%CI：0.48 - 0.87）。无进展生存率同样良好，3年时为95%（95%CI：89 - 101%），5年时为93%（95%CI：86 - 99%），10年时为81%（95%CI：51 - 111%）。汇总的放射性坏死率为5%（95%CI：3 - 7%），而总体放射毒性率为16%（95%CI：11 - 21%）。6个月时局部肿瘤控制率较高，12个月时为100%（95%CI：1.00 - 1.00）。