Systematic Review and Meta-analysis: Radiosurgery Outcomes in Cavernous Sinus Meningioma
Notice bibliographique
Résumé
Introduction: Meningiomas are the most common primary CNS tumors, with cavernous sinus meningiomas (CSMs) constituting 1% of intracranial tumors. Due to their location and potential invasion, CSMs are challenging to treat. Treatment methods have evolved from aggressive resections to less invasive techniques like stereotactic radiosurgery (SRS), which reduce morbidity and improve survival. This study reviews the effectiveness and safety of radiosurgery for CSMs, integrating historical and contemporary approaches to guide future treatments. Methods: A search was conducted in Medline, Embase, and Cochrane databases, adhering to Cochrane and PRISMA guidelines. Eligible studies included randomized or observational studies with at least four patients reporting on radiosurgery for CSM. A random-effects model was used to calculate a single proportion analysis with 95% confidence intervals. Statistical analyses were performed using RStudio. Clinical improvement was defined as partial or complete recovery of at least one preexisting cranial nerve or neurological deficit. Clinical deterioration was defined as the worsening or onset of new cranial nerve or neurological deficits. The design of progression-free survival analysis was considered according to the included studies. Results: The analysis included 51 studies with a total of 4,168 patients, and the median age was 57 years, ranging from 32 to 107 years. Males made up 60% of the cohort, and females 40%. The mean tumor volume was 10.9 cm 3 . Previous surgeries were reported in 569 patients (13.65%). Cranial nerve deficits were the most common symptom (80%), followed by extraocular neuropathy (55%), trigeminal neuropathy (31%), and visual acuity impairment (12%). Gamma Knife was the most used radiotherapy modality (45%), followed by LINAC (25%) and Cyber Knife (5%). The marginal dose ranged from 10 to 80 Gy, with an average of 18 Gy. The mean follow-up duration was about 50 months, ranging from 15 to 300 months. These data provide insights into patient demographics, treatment methods, and posttreatment monitoring strategies. Outcomes were as follows: the 10-year progression-free survival (PFS) rate was 90% (95% CI: 80–99%; I 2 = 85%; [ Fig. 1 ]), clinical deterioration occurred in 6% of cases (95% CI: 3–9%; I 2 = 71%; [ Fig. 2 ]), clinical improvement was observed in 36% of patients (95% CI: 28–43%; I 2 = 86%; [ Fig. 3 ]). Fig. 1 10-year progression-free survival. Fig. 2 Clinical deterioration. Fig. 3 Clinical improvement. Conclusion: This study demonstrates that SRS is an effective treatment for CSMs, offering high long-term PFS and significant tumor control with few complications. However, variations in SRS techniques and tumor characteristics highlight the need for standardized methods to refine treatment approaches. Publication History Article published online: 07 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,051 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,016 | 0,052 |
| Bibliométrie | 0,004 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».