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Long-term disease control and treatment outcomes of stereotactic radiosurgery in cavernous sinus meningiomas

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Abstract

Background

Most of the current knowledge on the clinical effects of stereotactic radiosurgery (SRS) on the treatment of cavernous sinus meningiomas (CSM) is based on series with limited follow-up. However, determining the role of radiation in a tumor with slow disease progression such as CSM necessitates long term follow up.

Objective

To review and pool metadata in the literature to determine the long-term outcomes of SRS with respect to clinical and radiographic tumor control of CSM.

Methods

A systematic search was conducted following MOOSE guidelines. Results were screened against predefined criteria, which excluded studies with a median follow-up less than 5 years. The incidences of each outcome were calculated using random-effects metanalysis of proportions.

Results

Seven studies met the inclusion criteria, comprising 645 patients. The median follow-up was 74 months (range 62–87). Progression-free-survival at 5, 10, and 15 years was 93.4% (95% CI 89.1–96.7%), 84.9% (95% CI 77–91.4%), and 81.3% (95% CI 74–87.7%), respectively. Clinical response to SRS at last follow-up defined as improvement of cranial nerve deficits was found in in 36.4% (95% CI 26.3–47.1%) of patients, while worsening or onset of new cranial nerve deficits was found in 11.5% (95% CI 7.9–15.7%). Radiological regression was found in 57.8% (95% CI 43–71.8%), while tumor progression was found in 8.5% (95% CI 5.2–12.6%).

Conclusion

SRS achieves excellent disease control and radiographic response in CSM. Although the risk of long-term cranial neuropathies is minimal, it is relatively higher to what has been previously reported in early series with limited follow-up.

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This manuscript has not been previously published in whole or in part or submitted elsewhere for review.

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Funding

This study did not receive any funding relative to its elaboration.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Colorado School of Medicine, 1635 Aurora Ct, 4th floor, Aurora, CO, 80045, USA

    Rafael Martinez-Perez, Lindsey Freeman, Timothy H. Ung & A. Samy Youssef

  2. Department of Medicine, Concejo Latinoamericano de Neurointensivismo-CLaNi, Cartagena, Colombia

    William Florez-Perdomo

  3. Department of Otolaryngology, University of Colorado School of Medicine, 1635 Aurora Ct, 4th floor, Aurora, CO, 80045, USA

    A. Samy Youssef

Authors
  1. Rafael Martinez-Perez
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  5. A. Samy Youssef
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Contributions

Conception and design of study: RM-P, acquisition of data: RM-P, WF-P; analysis and/or interpretation of data: RM-P, WF-P. Drafting the manuscript: RM-P, TU, LF; revising the manuscript critically for important intellectual content: SY; Approval of the version of the manuscript to be published: RM-P, WF-P, TU, LF, SY.

Corresponding authors

Correspondence to Rafael Martinez-Perez or A. Samy Youssef.

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Conflict of interest

ASY is a consultant for Stryker Corp and has received honorarium from Mizuho America.

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Ethical approval was not deemed necessary by the local ethics in view of the design of the study (metanalysis).

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Informed consent was not deemed necessary by the local ethics in view of the design of the study (metanalysis).

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Martinez-Perez, R., Florez-Perdomo, W., Freeman, L. et al. Long-term disease control and treatment outcomes of stereotactic radiosurgery in cavernous sinus meningiomas. J Neurooncol 152, 439–449 (2021). https://doi.org/10.1007/s11060-021-03732-8

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