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Single session versus multisession stereotactic radiosurgery for the management of intracranial meningiomas: a systematic review and meta-analysis

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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.

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Data availability

The authors confirms that data are available on reasonable requests.

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Acknowledgements

We thank Kristin Kraus, MSc, for her editorial assistance.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Othman Bin-Alamer, Arka N. Mallela, Zachary C. Gersey, Andrew D. Legarreta, L. Dade Lunsford & Hussam Abou-Al-Shaar

  2. Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia

    Nada Alnefaie

  3. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia

    Jumanah Qedair

  4. Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

    Adhiraj Chaudhary

  5. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

    Hana Hallak

  6. Department of Neurosurgery, Hannover Medical School, Hannover, Germany

    Arif Abdulbaki

  7. Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Paolo Palmisciano

  8. Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Mohamed A. Labib

  9. Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Gabriel Zada

  10. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA

    Jason P. Sheehan

  11. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA

    William T. Couldwell

Authors
  1. Othman Bin-Alamer
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  2. Nada Alnefaie
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Contributions

Conception and design: Bin Alamer, Abou-Al-Shaar. Literature search, articles screen, and data extraction: Bin Alamer, Alnefaie, Qedair, Chaudhary, Hallak, Abdulbaki, Mallela, Palmisciano, Gersey, Legarreta, Abou-Al-Shaar. Data analysis: Bin Alamer, Mallela, Palmisciano, Abou-Al-Shaar. Manuscript draft: Bin Alamer, Mallela, Gersey, Labib, Zada, Sheehan, Couldwell, Lunsford, Abou-Al-Shaar. All authors critically revised and edited the first draft and commented on all versions of the manuscript. The project was supervised by Labib, Zada, Sheehan, Couldwell, Lunsford, Abou-Al-Shaar. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hussam Abou-Al-Shaar.

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Dr Lunsford is a consultant for and stockholder in Elekta AB. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Bin-Alamer, O., Alnefaie, N., Qedair, J. et al. Single session versus multisession stereotactic radiosurgery for the management of intracranial meningiomas: a systematic review and meta-analysis. J Neurooncol 161, 215–224 (2023). https://doi.org/10.1007/s11060-022-04112-6

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