Single session versus multisession stereotactic radiosurgery for the management of intracranial meningiomas: a systematic review and meta-analysis

Purpose To compare the efficacy, outcomes, and complications of single session (SS-SRS) and multisession (MS-SRS) stereotactic radiosurgery in the treatment of intracranial meningiomas. Methods Relevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane. A systematic review an...

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Published in:Journal of neuro-oncology 2023, Vol.161 (2), p.215-224
Main Authors: Bin-Alamer, Othman, Alnefaie, Nada, Qedair, Jumanah, Chaudhary, Adhiraj, Hallak, Hana, Abdulbaki, Arif, Mallela, Arka N., Palmisciano, Paolo, Gersey, Zachary C., Legarreta, Andrew D., Labib, Mohamed A., Zada, Gabriel, Sheehan, Jason P., Couldwell, William T., Lunsford, L. Dade, Abou-Al-Shaar, Hussam
Format: Article
Language:English
Subjects:
Brain cancer
Humans
Medicine
Medicine & Public Health
Meningeal Neoplasms - radiotherapy
Meningeal Neoplasms - surgery
Meningioma
Meningioma - pathology
Meningioma - radiotherapy
Meningioma - surgery
Meta-analysis
Neurology
Oncology
Radiosurgery
Radiosurgery - methods
Retrospective Studies
Review
Systematic review
Treatment Outcome
Tumor Burden
Tumors
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Summary:Purpose To compare the efficacy, outcomes, and complications of single session (SS-SRS) and multisession (MS-SRS) stereotactic radiosurgery in the treatment of intracranial meningiomas. Methods Relevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane. A systematic review and meta-analysis of treatment protocols and outcomes were conducted. After the selection process, 20 articles describing 1483 cases were included. Results A total of 1303 patients who underwent SS-SRS and 180 patients who underwent MS-SRS for the management of their intracranial meningioma were reported in the included studies. SS-SRS and MS-SRS had comparable one-year (SS-SRS: 98% vs. MS-SRS: 100%, p  > 0.99) and five-year (SS-SRS: 94% vs. MS-SRS: 93%, p  = 0.71) tumor control rates. The groups also had comparable tumor volume reduction/tumor regression rates (SS-SRS: 44% vs. MS-SRS: 25%, p  = 0.25), tumor volume stability rates (SS-SRS: 51% vs. MS-SRS: 75%, p  = 0.12), and tumor progression rates (SS-SRS: 4% vs. MS-SRS: 4%, p  = 0.89). SS-SRS and MS-SRS yielded similar complication rates (10.4% vs. 11.4%, p  = 0.68) and comparable functional improvement rates (MS-SRS: 44% vs. SS-SRS: 36%, p  = 0.57). However, MS-SRS was used for significantly larger tumor volumes (MS-SRS: 23.8 cm 3 vs. SS-SRS: 6.1 cm 3 , p  = 0.02). Conclusion SS-SRS and MS-SRS resulted in comparable tumor control, tumor volumetric change, and functional outcomes despite significant biases in selecting patients for SS- or MS-SRS.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-022-04112-6