Stereotactic radiosurgery for cerebellopontine meningiomas: a systematic review and meta-analysis.

Publisher: Taylor & Francis Country of Publication: England NLM ID: 8800054 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-046X (Electronic) Linking ISSN: 02688697 NLM ISO Abbreviation: Br J Neurosurg Subsets: MEDLINE

Publication: 2015-: Abingdon, Oxfordshire : Taylor & Francis
Original Publication: Abingdon, Oxfordshire : Carfax Pub. Co., c1987-

Meningioma*/radiotherapy ; Meningioma*/surgery ; Meningioma*/complications ; Radiosurgery*/adverse effects ; Radiosurgery*/methods ; Hearing Loss*/complications ; Hearing Loss*/surgery ; Meningeal Neoplasms*/radiotherapy ; Meningeal Neoplasms*/surgery ; Meningeal Neoplasms*/complications; Humans ; Treatment Outcome ; Follow-Up Studies ; Retrospective Studies

Objective: To (1) measure surgical outcomes associated with stereotactic radiosurgery treatment of cerebellopontine angle meningiomas, and (2) determine if differences in radiation dosages or preoperative tumor volumes affect surgical outcomes.
Methods: A systematic search was performed on the PubMed, Medline, Embase and Cochrane Library databases searching for patients under stereotactic radiosurgery for meningiomas of the cerebellopontine angle. After data extraction and Newcastle-Ottawa scale quality assessment, meta-analysis of the data was performed with Review Manager 3.4.5.
Results: In total, 6 studies including 406 patients were included. Postprocedure, patients had minimal cranial nerve complications while having an overall tumor control rate of 95.6%. Complications were minimal with facial nerve deficits occurring in 2.4%, sensation deficits of the trigeminal nerve in 4.0%, hearing loss in 5.9%, hydrocephalus in 2.0% and diplopia in 2.6% of all patients. Individuals with tumors extending into the internal auditory canal extension did not have significantly increases in hearing loss. There was a higher likelihood of tumor regression on postprocedure imaging in studies with a median prescription dose of >13 Gy (RR 1.27 [95% CI 1.04-1.56, p  = 0.0225). There was no evidence of publication bias detected.
Conclusions: Radiosurgery is an effective modality for offering excellent tumor control of CPA meningiomas while allowing for only minimal complications postprocedure. A higher prescription dose may achieve higher tumor regression at follow up. Future studies should aim at establishing and optimizing accurate dosimetric guidelines for this patient population.

Keywords: Cerebellopontine angle; hearing preservation; marginal dose; maximal dose; meningioma; outcomes; postmeatal; premeatal; stereotactic radiosurgery

Date Created: 20220427 Date Completed: 20230322 Latest Revision: 20230322

20240829

10.1080/02688697.2022.2064425

35475408