Hypofractionated stereotactic radiotherapy/radiosurgery versus single-session stereotactic radiosurgery for patients with hemangioma of cavernous sinus: a systematic review, single-arm meta-analysis, and an indirect comparison.

Ahmadvand MH, Delbari P, Mirjani MS, +7 more, Sheehan JP.

ReviewOpen access

AI summary — for doctors, generated from the abstract only

A meta-analysis of 682 patients across 20 studies found that both single-session radiosurgery and hypofractionated radiotherapy are effective and safe for cavernous sinus hemangiomas, with substantial tumor shrinkage and low rates of radiation-related side effects, with hypofractionated treatment showing somewhat higher symptom recovery rates, particularly suited to larger tumors.

What was studied

A systematic review and single-arm meta-analysis (PubMed, Embase, Web of Science, Scopus, through March 2024) of 20 studies totaling 682 patients with cavernous sinus hemangiomas treated with either stereotactic radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (HSRT), evaluating tumor control, symptom relief, and safety, with an indirect comparison between the two treatment modalities.

Key findings

Pooled tumor volume reduction was substantial, estimated at 71% (95% CI 57-84%), with a standardized mean difference of -2.07 (95% CI -2.47 to -1.67).
Symptom recovery rates were numerically higher with HSRT (64%, 95% CI 9-119%, reflecting substantial variability) compared with SRS (44%, 95% CI 21-67%).
Adverse radiation effects were minimal overall, with a pooled rate of 5% (95% CI 2-7%); cranial nerve improvement was observed but varied by which nerve was affected and which treatment was used.

Clinical relevance

The findings suggest that both single-session radiosurgery and hypofractionated radiotherapy are reasonable, low-risk treatment options for cavernous sinus hemangiomas, with hypofractionated treatment potentially offering an advantage for larger tumors, information that could help guide modality selection, though the comparison between the two was indirect rather than head-to-head.

Who should care

Neurosurgery

Limitations

The comparison between SRS and HSRT was indirect (not from head-to-head randomized trials), and the very wide confidence interval for HSRT symptom recovery (9-119%) reflects substantial heterogeneity and small sample sizes in contributing studies.

Both stereotactic radiosurgery and hypofractionated radiotherapy produced substantial tumor shrinkage and low complication rates for cavernous sinus hemangiomas in this 682-patient meta-analysis, with hypofractionated treatment showing a possible edge for symptom recovery, especially in larger tumors.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Cavernous sinus hemangiomas (CSHs) are rare, benign vascular tumors with high morbidity due to their critical location and vascularity. While microsurgical resection was the historical standard, its risks of intraoperative bleeding and cranial nerve deficits have led to the adoption of stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (HSRT). This systematic review and meta-analysis evaluate outcomes of these modalities, focusing on tumor control, symptom relief, and safety.

Methods

Following PRISMA guidelines, a systematic search of PubMed, Embase, Web of Science, and Scopus (up to March 2024) identified studies reporting outcomes of SRS or HSRT in CSHs. Eligible studies were assessed for quality using the Joanna Briggs Institute checklist. All statistical analysis was performed using STATA v.17.

Results

Twenty studies with 682 patients were included. Tumor volume reduction was substantial, with a pooled estimate of 71% (95% CI: 57-84%) and a standardized mean difference of -2.07 (95% CI: -2.47 to -1.67). Symptom recovery rates were highest with HSRT (64%, 95% CI: 9-119%) compared to SRS (44%, 95% CI: 21-67%). Adverse radiation effects were minimal, with an overall rate of 5% (95% CI: 2-7%). Cranial nerve improvement was observed but varied by nerve and treatment type.

Conclusion

SRS and HSRT are effective and safe for CSHs, with HSRT showing particular benefits for larger tumors due to fractionation. Future studies should optimize protocols and refine patient selection to maximize therapeutic outcomes. Radiation-based therapies now represent a cornerstone in CSH management.

DOI

10.1007/s00701-026-06970-9

PMID

42414731

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in