PMID- 21152953
OWN - NLM
STAT- MEDLINE
DCOM- 20110915
LR  - 20220330
IS  - 1573-7373 (Electronic)
IS  - 0167-594X (Linking)
VI  - 103
IP  - 1
DP  - 2011 May
TI  - Stereotactic radiosurgery: a meta-analysis of current therapeutic applications in 
      neuro-oncologic disease.
PG  - 1-17
LID - 10.1007/s11060-010-0360-0 [doi]
AB  - Stereotactic radiosurgery (SRS) represents an important tool in neurosurgery and 
      radiotherapy for addressing a multitude of diseases, most notably in the field of 
      neuro-oncology. The pathologies for which it is employed vary significantly, and 
      few controlled studies exist to evaluate its efficacy. We aimed to provide a 
      quantitative meta-analysis of SRS applications in neuro-oncology, providing 
      benchmarks for expected outcomes. The meta-analysis was conducted in accordance 
      with established standards for evaluating observational data. Specific inclusion 
      criteria were utilized, search terms recorded, and data extracted to summarize 
      demographic and outcome statistics. Meta-analysis was conducted where 
      statistically appropriate, and clinical outcomes summarized as tumor stability, 
      survival, and complications in a pathology-specific manner. For vestibular 
      schwannoma, 37 studies with a total 3,677 patients were included. Overall disease 
      stabilization rate after adjustment for significant publication bias was 91.1%. 
      Non-cranial nerve complication rate after publication bias adjustment was 5.6%. 
      Accounting for publication bias, rate of hearing preservation was with 59.3%. For 
      456 glioblastoma multiforme (GBM) patients in 11 studies receiving SRS, median 
      survival from diagnosis was 13.5-26 months, while overall complication rate was 
      11.4%. For meningioma, 15 studies with a total 2,734 patients were included; 
      77.1% were classified as skull base. Overall disease stabilization rate was 89.0, 
      while overall complication rate was 7.0%. For metastatic disease, 27 studies with 
      a total of 2,679 patients were included. Overall median survival from time of SRS 
      was 5-14 months, overall 1-year survival rates were 15-54.9%, while reported 
      local disease control rates were 59.6-96.8%. Stereotactic radiosurgery is an 
      increasingly important tool in the management of neuro-oncologic diseases. While 
      there is a pathology-specific role for SRS, current data show excellent results 
      in treating several pathologies. As such, SRS adds significantly to the 
      neurosurgical armamentarium for treating neuro-oncologic processes.
FAU - Pannullo, Susan C
AU  - Pannullo SC
AD  - Department of Neurological Surgery, Weill Cornell Medical College-New York 
      Presbyterian Hospital, 525 E. 68th Street, P.O. Box 99, New York, NY 10065, USA.
FAU - Fraser, Justin F
AU  - Fraser JF
FAU - Moliterno, Jennifer
AU  - Moliterno J
FAU - Cobb, William
AU  - Cobb W
FAU - Stieg, Philip E
AU  - Stieg PE
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20101209
PL  - United States
TA  - J Neurooncol
JT  - Journal of neuro-oncology
JID - 8309335
SB  - IM
MH  - Brain Neoplasms/*surgery
MH  - Humans
MH  - Neurosurgical Procedures
MH  - *Radiosurgery
EDAT- 2010/12/15 06:00
MHDA- 2011/09/16 06:00
CRDT- 2010/12/15 06:00
PHST- 2009/11/10 00:00 [received]
PHST- 2010/08/09 00:00 [accepted]
PHST- 2010/12/15 06:00 [entrez]
PHST- 2010/12/15 06:00 [pubmed]
PHST- 2011/09/16 06:00 [medline]
AID - 10.1007/s11060-010-0360-0 [doi]
PST - ppublish
SO  - J Neurooncol. 2011 May;103(1):1-17. doi: 10.1007/s11060-010-0360-0. Epub 2010 Dec 
      9.