P13.04.A craniopharyngioma treatment: protons VS. photons - a systematic review and meta-analysis
Abstract
Craniopharyngiomas are complex tumors that can present significant challenges for neurosurgeons, sometimes necessitating a range of treatment modalities, including radiotherapy.
Through a systematic review and meta-analysis, this study evaluates the effectiveness and safety of proton beam therapy compared to traditional photon therapy for craniopharyngioma treatment. We searched major databases (Pubmed, Cochrane, and Scopus) for studies comparing proton and photon therapy for craniopharyngioma. Studies published up until April 2024 were included. We assessed event-free survival and endocrine dysfunction. The risk of bias in each study was evaluated. Pooled estimates of odds ratios using random-effects models were calculated for each outcome for patients undergoing proton versus photon therapies.
This systematic review analyzed data from three non-randomized studies, encompassing 375 patients who received subtotal resection followed by radiation therapy for residual tumors. Patients were divided into two groups: photon therapy (n=147, 39.2%) and proton therapy (n=228, 60.8%). With a median follow-up of 5.0 to 6.4 years, the meta-analysis revealed no significant difference in event-free survival (log OR=-0.28, 95%CI=-1.49-0.93, p=0.65) or endocrine dysfunction (log OR=0.12, 95%CI=-0.36-0.60, p=0.62) between the proton and photon therapy groups. Heterogeneity among studies was low to moderate (I²=50.59% for event-free survival, I²=0.00% for endocrine dysfunction).
This review…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 375 participants or records.
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