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Stereotactic radiosurgery for intraventricular meningioma: a systematic review and meta-analysis
Alireza Soltani Khaboushan1,2,3, Mohammad Amin Dabbagh Ohadi1,3, Hanieh Amani4
1School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Intraventricular meningioma (IVM) is a rare subtype of intracranial meningioma, accounting for 9.8 to 14% of all intraventricular tumors. Currently, there is no clear consensus on which patients with IVM should receive conservative treatment, surgery, or stereotactic radiosurgery (SRS). This research aims to analyze the outcomes, including survival and recurrence rates of patients who undergo SRS for IVM as a primary or adjuvant treatment.
Methods:
A systematic search was conducted in Scopus, Web of Science, PubMed, and Embase till June 5th 2023. Screening and data extraction were performed by two independent authors. Random-effect meta-analysis was performed to determine the tumor control proportion of IVM cases treated with SRS. Individual patient data (IPD) meta-analysis was performed for the progression-free survival (PFS) of the patients in the follow-up time. All analyses were performed using the R programming language.
Results:
Out of the overall 132 records, 14 were included in our study, of which only 7 had enough data for the meta-analysis. The tumor control proportion was 0.92 (95% CI, 0.69-0.98) in patients who underwent SRS for primary IVM. The overall tumor control in both primary and adjuvant cases was 0.87 (95% CI, 0.34-0.99). the heterogeneity was not significant in both meta-analyses (P = 0.73 and P = 0.92, respectively). Post-SRS perifocal edema occurred in 16 out of 71 cases (0.16; 95% CI, 0.03-0.56), with no significant heterogeneity (P = 0.32). IPD meta-analysis showed a PFS of 94.70% in a 2-year follow-up. Log-rank test showed better PFS in primary SRS compared to adjuvant SRS (P < 0.01).
Conclusions:
According to this study, patients with IVM can achieve high rates of tumor control with a low risk of complications when treated with SRS, regardless of whether they have received prior treatment. Although SRS could be a promising first-line treatment option for asymptomatic IVM, its efficacy in symptomatic patients and its comparison with resection require further investigation.
Insights
Stereotactic radiosurgery (SRS) offers high tumor control for intraventricular meningioma (IVM) with low complication rates. Primary SRS shows better progression-free survival than adjuvant SRS for IVM treatment.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Intraventricular meningioma (IVM) is a rare intracranial tumor with no consensus on optimal treatment.
- This study evaluates stereotactic radiosurgery (SRS) outcomes for IVM, analyzing survival and recurrence rates.
Approach:
- A systematic review and meta-analysis of studies on SRS for IVM was conducted.
- Data from Scopus, Web of Science, PubMed, and Embase were analyzed.
- Individual patient data meta-analysis assessed progression-free survival (PFS).
Key Points:
- Primary SRS achieved a tumor control proportion of 0.92.
- Overall tumor control for primary and adjuvant SRS was 0.87.
- Two-year PFS was 94.70%, with primary SRS demonstrating superior PFS compared to adjuvant SRS.
Conclusions:
- SRS provides high tumor control and low complication rates for IVM patients.
- SRS is a promising first-line option for asymptomatic IVM.
- Further research is needed for symptomatic cases and comparison with surgical resection.
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