Desfecho de curto e longo prazo da radiocirurgia Gamma Knife para malformações cavernosas cerebrais: meta-análise de dados reconstruídos de tempo para evento

Abstract

Introduction: Cavernomas are vascular lesions of genetic origin that can be identified in the central nervous system. When these lesions are located in eloquent brain regions, surgical resection is not recommended. In such cases, Gamma Knife stereotactic radiosurgery (GKRS) may be a viable treatment option. Therefore, our objective is to explore the outcomes associated with this procedure. Methods: We conducted a systematic review and meta-analysis of reconstructed time-to-event data based on Kaplan-Meier curves. A comprehensive search was performed in the PubMed, Cochrane, Web of Science, and Embase databases, aiming to identify articles that provided information on hemorrhagic outcomes associated with GKRS through Kaplan-Meier curves. Results: Following a systematic search of the specified databases, seven studies were included in this review. Notably, a total of 1,071 patients had 1,104 cavernomas treated with GKRS. Evaluation of short- and long-term post-procedure outcomes was conducted, with the estimated event-free rate at 2 years being 89.8% (95% CI 87.7–91.5), while at 10 years, the estimated event-free rate was 71.3% (95% CI 67.2–75.1). Conclusion: GKRS appears to be a good alternative for the control of symptomatic events in both short- and long-term follow-up, although further investigation through future studies is warranted.