Introduction

Numerous studies have demonstrated Fractionated Stereotactic Radiotherapy's (FSRT) effectiveness in tumor control post-resection for craniopharyngiomas. Nevertheless, past literature has presented conflicting findings particularly regarding endocrine and visual function outcomes. This study aims to elucidate FSRT's efficacy and safety for this population.

Methods

Adhering to PRISMA, a systematic review and meta-analyses was conducted. Included studies had to report the effects of FSRT for treating craniopharyngiomas in a sample greater than four patients, addressing at least one of the outcomes of interest: improvement in visual acuity or field, new-onset hypopituitarism, effectiveness, and tumor progression. Relative risk with 95% confidence intervals were used to assess the outcomes.

Results

After retrieving a total of 1292 studies, 10 articles met the predefined criteria and thus were finally selected, amounting to a total of 256 patients. The improvement in visual acuity was estimated at 45% (95% CI: 6–83%), while the improvement in the visual field was 22% (95% CI: 0–51%). Regarding endocrine function, the new-onset hypopituitarism rate was found to be 5% (95% CI: 0–11%). Relative to FSRT effectiveness, the pooled estimate of the complete tumor response rate was 17% (95% CI: 4–30%), and the tumor progression rate was 7% (95% CI: 1–13%). Also, a 3-year progression-free survival rate of 98% (95% CI: 95–100%) was obtained.

Conclusion

Despite limitations and risks, FSRT shows promise as a viable therapeutic option for craniopharyngiomas, offering notable benefits for visual functions and tumor control. Further research is required to better understand the associated risks, benefits, and clinical utility.

中文翻译：

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颅咽管瘤分割立体定向放射治疗：系统评价和单臂荟萃分析

介绍

大量研究表明，分割立体定向放射治疗 (FSRT) 在颅咽管瘤切除后肿瘤控制方面的有效性。然而，过去的文献提出了相互矛盾的发现，特别是在内分泌和视觉功能结果方面。本研究旨在阐明 FSRT 对这一人群的有效性和安全性。

方法

遵循 PRISMA，进行了系统评价和荟萃分析。纳入的研究必须报告 FSRT 在超过 4 名患者的样本中治疗颅咽管瘤的效果，至少解决一个感兴趣的结果：视力或视野的改善、新发垂体功能减退、有效性和肿瘤进展。使用 95% 置信区间的相对风险来评估结果。

结果

共检索1292篇研究，最终入选10篇符合预定标准的文章，共计256名患者。视力改善估计为 45% (95% CI: 6–83%)，而视野改善为 22% (95% CI: 0–51%)。关于内分泌功能，新发垂体功能减退症发生率为 5%（95% CI：0-11%）。相对于 FSRT 有效性，肿瘤完全缓解率的汇总估计值为 17%（95% CI：4-30%），肿瘤进展率为 7%（95% CI：1-13%）。此外，3 年无进展生存率为 98%（95% CI：95-100%）。

结论

尽管存在局限性和风险，FSRT 作为颅咽管瘤的一种可行的治疗选择显示出了前景，为视觉功能和肿瘤控制提供了显着的益处。需要进一步研究以更好地了解相关的风险、益处和临床效用。