Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis
Abstract Background The pituitary gland is an infrequent site for metastasis, encompassing approximately 0.4% of all intracranial metastatic lesions. The prognosis of pituitary metastasis (PM) remains dismal despite considerable advances in therapeutic interventions. Stereotactic radiosurgery (SRS)...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-025-02640-9 |
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| author | Bardia Hajikarimloo Salem M. Tos Mohammadamin Sabbagh Alvani Alireza Kooshki Ibrahim Mohammadzadeh Dorsa Najari Mohammad Amin Habibi |
| author_facet | Bardia Hajikarimloo Salem M. Tos Mohammadamin Sabbagh Alvani Alireza Kooshki Ibrahim Mohammadzadeh Dorsa Najari Mohammad Amin Habibi |
| author_sort | Bardia Hajikarimloo |
| collection | DOAJ |
| description | Abstract Background The pituitary gland is an infrequent site for metastasis, encompassing approximately 0.4% of all intracranial metastatic lesions. The prognosis of pituitary metastasis (PM) remains dismal despite considerable advances in therapeutic interventions. Stereotactic radiosurgery (SRS) has been increasingly utilized as a minimally invasive therapeutic option for PMs. This study evaluated the efficacy and safety of SRS in patients with PMs. Methods On November 26, 2024, a systematic search was conducted through PubMed, Embase, Scopus, and Web of Science. Studies that have evaluated the role of SRS in PMs or PMs with cavernous sinus invasion were included. The meta-analysis, sensitivity analysis, publication bias evaluation, and meta-regression were conducted using the R program. Results Seven studies with 79 individuals with PMs were included. The results showed a pooled local control (LC) rate of 92% (95%CI:83–98%) following intervention. The analysis resulted in a pooled diabetes insipidus (DI) improvement rate of 42% (95%CI:0–100%) and cranial nerve (CN) dysfunction improvement rate of 77% (95%CI:49–98%). In contrast, none of the patients with anterior pituitary dysfunction experienced improvement. The meta-analysis revealed a pooled ARE rate of 2% (95%CI:0–7%) with low heterogeneity (I2 = 0%, P = 0.93). The subgroup analysis for single-session SRS revealed a pooled LC rate of 90% (95%CI:80–98%) and a pooled ARE rate of 2% (95%CI:0–8%). Conclusion SRS is correlated with promising improvement in LC, OS, and CN dysfunction in patients with PM. On the other hand, SRS is accompanied by limited effectiveness in DI and improvement in anterior pituitary dysfunction due to irreversible damage to the pituitary cells by metastatic lesions. |
| format | Article |
| id | doaj-art-b00a4c3e6d9149afa3bf510c86bf3da7 |
| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-b00a4c3e6d9149afa3bf510c86bf3da72025-08-20T03:48:18ZengBMCRadiation Oncology1748-717X2025-05-0120111110.1186/s13014-025-02640-9Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysisBardia Hajikarimloo0Salem M. Tos1Mohammadamin Sabbagh Alvani2Alireza Kooshki3Ibrahim Mohammadzadeh4Dorsa Najari5Mohammad Amin Habibi6Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical SciencesDepartment of Neurological Surgery, University of VirginiaDepartment of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical SciencesStudent Research Committee, Birjand University of Medical SciencesSkull Base Research Center, Loghman-Hakim Hospital, Shahid Beheshti University of Medical SciencesDepartment of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical SciencesDepartment of Neurosurgery, Shariati Hospital, Tehran University of Medical SciencesAbstract Background The pituitary gland is an infrequent site for metastasis, encompassing approximately 0.4% of all intracranial metastatic lesions. The prognosis of pituitary metastasis (PM) remains dismal despite considerable advances in therapeutic interventions. Stereotactic radiosurgery (SRS) has been increasingly utilized as a minimally invasive therapeutic option for PMs. This study evaluated the efficacy and safety of SRS in patients with PMs. Methods On November 26, 2024, a systematic search was conducted through PubMed, Embase, Scopus, and Web of Science. Studies that have evaluated the role of SRS in PMs or PMs with cavernous sinus invasion were included. The meta-analysis, sensitivity analysis, publication bias evaluation, and meta-regression were conducted using the R program. Results Seven studies with 79 individuals with PMs were included. The results showed a pooled local control (LC) rate of 92% (95%CI:83–98%) following intervention. The analysis resulted in a pooled diabetes insipidus (DI) improvement rate of 42% (95%CI:0–100%) and cranial nerve (CN) dysfunction improvement rate of 77% (95%CI:49–98%). In contrast, none of the patients with anterior pituitary dysfunction experienced improvement. The meta-analysis revealed a pooled ARE rate of 2% (95%CI:0–7%) with low heterogeneity (I2 = 0%, P = 0.93). The subgroup analysis for single-session SRS revealed a pooled LC rate of 90% (95%CI:80–98%) and a pooled ARE rate of 2% (95%CI:0–8%). Conclusion SRS is correlated with promising improvement in LC, OS, and CN dysfunction in patients with PM. On the other hand, SRS is accompanied by limited effectiveness in DI and improvement in anterior pituitary dysfunction due to irreversible damage to the pituitary cells by metastatic lesions.https://doi.org/10.1186/s13014-025-02640-9Stereotactic radiosurgeryPituitary metastasisGamma knifeCavernous sinus |
| spellingShingle | Bardia Hajikarimloo Salem M. Tos Mohammadamin Sabbagh Alvani Alireza Kooshki Ibrahim Mohammadzadeh Dorsa Najari Mohammad Amin Habibi Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis Radiation Oncology Stereotactic radiosurgery Pituitary metastasis Gamma knife Cavernous sinus |
| title | Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis |
| title_full | Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis |
| title_fullStr | Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis |
| title_full_unstemmed | Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis |
| title_short | Stereotactic radiosurgery in pituitary metastases: a systematic review and meta-analysis |
| title_sort | stereotactic radiosurgery in pituitary metastases a systematic review and meta analysis |
| topic | Stereotactic radiosurgery Pituitary metastasis Gamma knife Cavernous sinus |
| url | https://doi.org/10.1186/s13014-025-02640-9 |
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