METHODS: PubMed, Ovid Embase, and Ovid Medline electronic databases were searched. The primary outcome is hemorrhage rate and this meta-analysis is performed.
RESULTS: Nine studies are included in this meta-analysis. The overall risk ratio (RR) of hemorrhage rate of pre-GKRS and post-GKRS is 6.08 (95% confidence interval [CI], 5.04-7.35). The overall RR is 3.03 (95% CI, 2.65-4.11) between the hemorrhage rate of pre-GKRS and the first 2 years postradiosurgery, and the overall RR is 12.13 (95% CI, 1.73-85.07) comparing pre-GKRS with 2 years after GKRS. There is no significant difference of the hemorrhage rate between the first 2 years postradiosurgery and 2 years after GKRS (RR = 2.81; 95% CI, 0.20-13.42). The neurologic deficiency is the most common radiosurgery-related complication.
CONCLUSIONS: Patients with cerebral cavernous malformations, especially ones that were deep seated and surgically inaccessible, seem to benefit from GKRS owing to a reduction of annual hemorrhage rate in the first 2 years and 2 years after, despite several cases that suffer from negative side effects of radiation.
方法:PubMed,OvidEmbase,搜索了OvidMedline电子数据库。主要结果是出血率,进行了荟萃分析。
结果:本荟萃分析包括9项研究。GKRS前和GKRS后出血率的总体风险比(RR)为6.08(95%置信区间[CI],5.04-7.35)。术前GKRS和术后前2年的出血率之间的总RR为3.03(95%CI,2.65-4.11),与GKRS前和GKRS后2年相比,总RR为12.13(95%CI,1.73-85.07)。术后前2年和术后2年出血率无统计学差异(RR=2.81;95%CI,0.20-13.42)。神经系统缺陷是最常见的放射外科相关并发症。
结论:脑海绵状畸形患者,尤其是那些坐得很深,手术无法接近的人,由于前2年和后2年的年出血率降低,似乎受益于GKRS,尽管有几例遭受辐射的负面副作用。