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- Title
Fractionated stereotactic radiotherapy in craniopharyngiomas: A systematic review and single arm meta-analysis.
- Authors
Palavani, Lucca B.; Silva, Guilherme Melo; Borges, Pedro G. L. B.; Ferreira, Márcio Yuri; Sousa, Marcelo Porto; Leite, Marianna G. H. S. J.; Oliveira, Leonardo de Barros; Batista, Sávio; Bertani, Raphael; Polverini, Allan Dias; Beer-Furlan, André; Paiva, Wellingson
- Abstract
Introduction: Numerous studies have demonstrated Fractionated Stereotactic Radiotherapy's (FSRT) effectiveness in tumor control post-resection for craniopharyngiomas. Nevertheless, past literature has presented conflicting findings particularly regarding endocrine and visual function outcomes. This study aims to elucidate FSRT's efficacy and safety for this population. Methods: Adhering to PRISMA, a systematic review and meta-analyses was conducted. Included studies had to report the effects of FSRT for treating craniopharyngiomas in a sample greater than four patients, addressing at least one of the outcomes of interest: improvement in visual acuity or field, new-onset hypopituitarism, effectiveness, and tumor progression. Relative risk with 95% confidence intervals were used to assess the outcomes. Results: After retrieving a total of 1292 studies, 10 articles met the predefined criteria and thus were finally selected, amounting to a total of 256 patients. The improvement in visual acuity was estimated at 45% (95% CI: 6–83%), while the improvement in the visual field was 22% (95% CI: 0–51%). Regarding endocrine function, the new-onset hypopituitarism rate was found to be 5% (95% CI: 0–11%). Relative to FSRT effectiveness, the pooled estimate of the complete tumor response rate was 17% (95% CI: 4–30%), and the tumor progression rate was 7% (95% CI: 1–13%). Also, a 3-year progression-free survival rate of 98% (95% CI: 95–100%) was obtained. Conclusion: Despite limitations and risks, FSRT shows promise as a viable therapeutic option for craniopharyngiomas, offering notable benefits for visual functions and tumor control. Further research is required to better understand the associated risks, benefits, and clinical utility.
- Subjects
STEREOTACTIC radiotherapy; CRANIOPHARYNGIOMA; VISION; VISUAL fields; VISUAL acuity; PROGRESSION-free survival
- Publication
Journal of Neuro-Oncology, 2024, Vol 167, Issue 3, p373
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-024-04621-6