Single fraction and hypofractionated radiosurgery for perioptic meningiomas —tumor control and visual outcomes: a systematic review and meta-analysis

AbstractPerioptic meningiomas, defined as those that are less than 3  mm from the optic apparatus, are challenging to treat with stereotactic radiosurgery (SRS). Tumor control must be weighed against the risk of radiation-induced optic neuropathy (RION), as both tumor progression and RION can lead to visual decline. We performed a systematic review and meta-analysis of single fraction SRS and hypofractionated radiosurgery (hfRS) for perioptic meningiomas, evaluating tumor control and visual preservation rates. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we reviewed articles published between 1968 and Decemb er 8, 2022. We retained 5 studies reporting 865 patients, 438 cases treated in single fraction, while 427 with hfRS. For single fraction SRS, the overall rate of tumor control was 95.1%, with actuarial rates at 5 and 10 years of 96% and 89%, respectively; tumor progression was 7.7%. The rate of vis ual stability was 90.4%, including visual improvement in 29.3%. The rate of visual decline was 9.6%, including blindness in 1.2%. For hfRS, the overall rate of tumor control was 95.6% (range 92.1 –99.1,p <  0.001); tumor progression was 4.4% (range 0.9–7.9,p = 0.01). Overall rate of visual stability was 94.9% (range 90.9–98.9,p <  0.001), including visual improvement in 22.7% (range 5.0–40.3,p = 0.01); visual decline was 5.1% (range 1.1–9.1,p = 0.013). SRS is an effective and safe treatme...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research