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.
CONCLUSIONS: 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.
方法:坚持PRISMA,我们进行了系统评价和荟萃分析.纳入的研究必须报告FSRT在超过四名患者的样本中治疗颅咽管瘤的效果,解决至少一个感兴趣的结果: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评估结果。
结果:检索了总共1292项研究,10篇文章符合预定标准,因此最终被选中,总计256名患者。视力的改善估计为45%(95%CI:6-83%),而视野改善为22%(95%CI:0-51%)。关于内分泌功能,发现新发垂体功能减退率为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有望成为颅咽管瘤的可行治疗选择,为视觉功能和肿瘤控制提供显著的好处。需要进一步研究以更好地了解相关风险,好处,和临床效用。