Radiosurgery in Grade II and III Meningiomas: A Systematic Review and Meta-Analysis

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Meningiomas are the most common benign brain tumors.
• Invasive subtypes (grades II and III) pose significant treatment challenges due to rapid recurrence.
• Stereotactic radiosurgery is explored for managing high-grade meningiomas.

Purpose of the Study:

• To evaluate the efficacy of stereotactic radiosurgery in treating high-grade meningiomas (grades II and III).
• To analyze overall survival and progression-free survival rates in patients treated with stereotactic radiosurgery.

Main Methods:

• A systematic literature search was conducted on Medline via PubMed from inception to December 2022.
• Studies involving stereotactic radiation therapy for grade II-III meningiomas were included, adhering to PRISMA guidelines.
• Data from 29 articles encompassing 1446 patients were analyzed.

Main Results:

• Pooled overall survival rates for grade II meningiomas at 1, 2, 5, and 10 years were 0.96, 0.89, 0.81, and 0.66, respectively.
• Pooled overall survival rates for grade III meningiomas at 2, 5, and 10 years were 0.64, 0.41, and 0.19, respectively.
• The study included analyses of atypical (grade II) and anaplastic (grade III) meningiomas.

Conclusions:

• Stereotactic radiation therapy demonstrates promising outcomes for high-grade meningiomas.
• Further long-term prospective studies are needed to solidify these findings.
• The treatment appears beneficial for both overall outcome and progression-free survival.