Othman Bin-Alamer1, Nada Alnefaie2, Jumanah Qedair3, Adhiraj Chaudhary4, Hana Hallak5, Arif Abdulbaki6, Arka N Mallela1, Paolo Palmisciano7, Zachary C Gersey1, Andrew D Legarreta1, Mohamed A Labib8, Gabriel Zada9, Jason P Sheehan10, William T Couldwell11, L Dade Lunsford1, Hussam Abou-Al-Shaar12. 1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 2. Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia. 3. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. 4. Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. 5. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 6. Department of Neurosurgery, Hannover Medical School, Hannover, Germany. 7. Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 8. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA. 9. Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 10. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA. 11. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA. 12. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. aboualshaarh@upmc.edu.
Abstract
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 cm3 vs. SS-SRS: 6.1 cm3, 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.
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 cm3 vs. SS-SRS: 6.1 cm3, 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.
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