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Abstract：
BACKGROUND: Intraventricular meningioma (IVM) is a rare subtype of intracranial meningioma, accounting for 9.8 to 14% of all intraventricular tumors. Currently, there is no clear consensus on which patients with IVM should receive conservative treatment, surgery, or stereotactic radiosurgery (SRS). This research aims to analyze the outcomes, including survival and recurrence rates of patients who undergo SRS for IVM as a primary or adjuvant treatment.
METHODS: A systematic search was conducted in Scopus, Web of Science, PubMed, and Embase till June 5th 2023. Screening and data extraction were performed by two independent authors. Random-effect meta-analysis was performed to determine the tumor control proportion of IVM cases treated with SRS. Individual patient data (IPD) meta-analysis was performed for the progression-free survival (PFS) of the patients in the follow-up time. All analyses were performed using the R programming language.
RESULTS: Out of the overall 132 records, 14 were included in our study, of which only 7 had enough data for the meta-analysis. The tumor control proportion was 0.92 (95% CI, 0.69-0.98) in patients who underwent SRS for primary IVM. The overall tumor control in both primary and adjuvant cases was 0.87 (95% CI, 0.34-0.99). the heterogeneity was not significant in both meta-analyses (P = 0.73 and P = 0.92, respectively). Post-SRS perifocal edema occurred in 16 out of 71 cases (0.16; 95% CI, 0.03-0.56), with no significant heterogeneity (P = 0.32). IPD meta-analysis showed a PFS of 94.70% in a 2-year follow-up. Log-rank test showed better PFS in primary SRS compared to adjuvant SRS (P < 0.01).
CONCLUSIONS: According to this study, patients with IVM can achieve high rates of tumor control with a low risk of complications when treated with SRS, regardless of whether they have received prior treatment. Although SRS could be a promising first-line treatment option for asymptomatic IVM, its efficacy in symptomatic patients and its comparison with resection require further investigation.
METHODS: A systematic search was conducted in Scopus, Web of Science, PubMed, and Embase till June 5th 2023. Screening and data extraction were performed by two independent authors. Random-effect meta-analysis was performed to determine the tumor control proportion of IVM cases treated with SRS. Individual patient data (IPD) meta-analysis was performed for the progression-free survival (PFS) of the patients in the follow-up time. All analyses were performed using the R programming language.
RESULTS: Out of the overall 132 records, 14 were included in our study, of which only 7 had enough data for the meta-analysis. The tumor control proportion was 0.92 (95% CI, 0.69-0.98) in patients who underwent SRS for primary IVM. The overall tumor control in both primary and adjuvant cases was 0.87 (95% CI, 0.34-0.99). the heterogeneity was not significant in both meta-analyses (P = 0.73 and P = 0.92, respectively). Post-SRS perifocal edema occurred in 16 out of 71 cases (0.16; 95% CI, 0.03-0.56), with no significant heterogeneity (P = 0.32). IPD meta-analysis showed a PFS of 94.70% in a 2-year follow-up. Log-rank test showed better PFS in primary SRS compared to adjuvant SRS (P < 0.01).
CONCLUSIONS: According to this study, patients with IVM can achieve high rates of tumor control with a low risk of complications when treated with SRS, regardless of whether they have received prior treatment. Although SRS could be a promising first-line treatment option for asymptomatic IVM, its efficacy in symptomatic patients and its comparison with resection require further investigation.
摘要：
背景：脑室内脑膜瘤（IVM）是颅内脑膜瘤的一种罕见亚型，占所有脑室内肿瘤的9.8％至14％。目前,对于哪些IVM患者应接受保守治疗尚无明确共识，手术,或立体定向放射外科（SRS）。这项研究旨在分析结果，包括接受SRS作为主要或辅助治疗的IVM患者的生存率和复发率。
方法：在Scopus进行了系统搜索，WebofScience,PubMed,和Embase直到2023年6月5日。筛选和数据提取由两名独立作者进行。进行随机效应荟萃分析以确定接受SRS治疗的IVM病例的肿瘤控制比例。对随访时间内患者的无进展生存期(PFS)进行个体患者数据(IPD)Meta分析。所有分析均使用R编程语言进行。
结果：在总共132条记录中，14个被纳入我们的研究，其中只有7人有足够的数据进行荟萃分析。在因原发性IVM而接受SRS的患者中，肿瘤控制比例为0.92（95％CI，0.69-0.98）。原发和辅助病例的总体肿瘤控制为0.87（95％CI，0.34-0.99）。两种meta分析的异质性均不显著(分别为P=0.73和P=0.92).71例中有16例发生SRS后病灶周围水肿（0.16;95％CI，0.03-0.56），无显著异质性(P=0.32)。IPD荟萃分析显示，2年随访的PFS为94.70%。与辅助SRS相比，Log-rank检验显示主要SRS的PFS更好（P<0.01）。
结论：根据这项研究，使用SRS治疗时，IVM患者可以实现较高的肿瘤控制率和较低的并发症风险，不管他们以前是否接受过治疗。尽管SRS可能是无症状IVM的有希望的一线治疗选择，其在有症状患者中的疗效及其与切除术的比较需要进一步研究.
方法：在Scopus进行了系统搜索，WebofScience,PubMed,和Embase直到2023年6月5日。筛选和数据提取由两名独立作者进行。进行随机效应荟萃分析以确定接受SRS治疗的IVM病例的肿瘤控制比例。对随访时间内患者的无进展生存期(PFS)进行个体患者数据(IPD)Meta分析。所有分析均使用R编程语言进行。
结果：在总共132条记录中，14个被纳入我们的研究，其中只有7人有足够的数据进行荟萃分析。在因原发性IVM而接受SRS的患者中，肿瘤控制比例为0.92（95％CI，0.69-0.98）。原发和辅助病例的总体肿瘤控制为0.87（95％CI，0.34-0.99）。两种meta分析的异质性均不显著(分别为P=0.73和P=0.92).71例中有16例发生SRS后病灶周围水肿（0.16;95％CI，0.03-0.56），无显著异质性(P=0.32)。IPD荟萃分析显示，2年随访的PFS为94.70%。与辅助SRS相比，Log-rank检验显示主要SRS的PFS更好（P<0.01）。
结论：根据这项研究，使用SRS治疗时，IVM患者可以实现较高的肿瘤控制率和较低的并发症风险，不管他们以前是否接受过治疗。尽管SRS可能是无症状IVM的有希望的一线治疗选择，其在有症状患者中的疗效及其与切除术的比较需要进一步研究.
