{Reference Type}: Systematic Review
{Title}: Fractionated stereotactic radiotherapy in craniopharyngiomas: A systematic review and single arm meta-analysis.
{Author}: Palavani LB;Silva GM;Borges PGLB;Ferreira MY;Sousa MP;Leite MGHSJ;Oliveira LB;Batista S;Bertani R;Polverini AD;Beer-Furlan A;Paiva W;
{Journal}: J Neurooncol
{Volume}: 167
{Issue}: 3
{Year}: 2024 May 8
{Factor}: 4.506
{DOI}: 10.1007/s11060-024-04621-6
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.