Abstract：
BACKGROUND: 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.
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.
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.
摘要：
背景：许多研究已经证明，在颅咽管瘤切除术后的肿瘤控制中，分段立体定向放疗（FSRT）的有效性。然而，过去的文献提出了相互矛盾的发现,特别是关于内分泌和视觉功能结局.本研究旨在阐明FSRT对该人群的疗效和安全性。
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。
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。
