Introduction: Benign intradural spinal tumors, such as meningiomas and schwannomas, can cause neurological symptoms and impact quality of life. Conventional treatments, while effective, may have limitations in patients with high surgical risk. Spinal stereotactic radiosurgery (SRS) offers a minimally invasive option with precise targeting. To evaluate the efficacy and safety of SRS compared to conventional treatments for benign intradural spinal tumors, with a specific focus on tumor control rates and overall survival assessed at 1 and 3 years.
Methods: A systematic search was conducted in the PubMed, Embase, and ScienceDirect databases. Inclusion criteria encompassed randomized clinical trials and observational studies comparing SRS to conventional treatments, with outcomes on tumor local control rate and overall survival. Combined outcome estimates were calculated using a random-effects model due to study heterogeneity. Results were expressed with 95% confidence intervals, and heterogeneity was assessed using the I² statistic.
Results: Six studies with 288 patients evaluated the 1-year local control rate for SRS, with a combined rate of 0.92 (95% CI: 0.84–0.99; p < 0.01; I² = 83%) in the random-effects model. Five studies with 172 patients indicated sustained efficacy at 3 years, with a combined rate of 1.00 (95% CI: 0.98–1.00; p = 0.05; I² = 57%). In seven studies with 443 patients, the 1-year overall survival rate was 0.79 (95% CI: 0.66–0.92; p < 0.01; I² = 88%) in the random-effects model. Four studies with 163 patients showed a 3-year overall survival rate of 0.47 (95% CI: 0.33–0.62; p = 0.02; I² = 69%), reflecting variability among the studies.
Conclusion : This meta-analysis reveals that SRS provides a high tumor control rate compared to conventional therapies. Despite effective local control, long-term overall survival remains limited, indicating that the benefit in tumor control does not necessarily translate into a survival advantage.
.jpg)