The Treatment Outcomes of Radiotherapy and Surgical Treatment for Patients with Cavernous Sinus Hemangioma: A Meta-Analysis

Abstract

Cavernous sinus hemangiomas (CSHs) are infrequent benign neoplasms. This meta-analysis was conducted with the objective of examining the prognostic outcomes of surgical interventions and radiotherapy in patients diagnosed with CSHs. A comprehensive literature search was performed across PubMed, Embase, and Web of Science databases, with traceability up to June 22, 2021. The evaluation of continuous variables was conducted by applying the Weighted Mean Difference (WMD) and 95% Confidence Interval (CI). A one-arm meta-analysis was used to scrutinize the tumor control rate (TCR), clinical improvement rate (CIR), recovery rates of abducens nerve palsy and visual disturbance, total resection rate (TRR), and the incidence rate of permanent nerve palsy post-treatment. In total, 29 articles were incorporated into the meta-analysis. Post-radiotherapy for CSHs, a significant reduction in tumor volume was observed (WMD [95% CI] = -17.16 [-21.52, -12.80] cm3). The TCR, CIR, recovery rate of abducens nerve palsy, and the recovery rate of visual disturbance were 97.1 (92.9, 99.7)%, 91.9 (82.3, 98.5)%, 95.6 (83.2, 100.0)%, and 86.3 (65.0, 99.5)%, respectively. Following surgical treatment, the TRR, mean intraoperative blood loss, recovery rate of visual disturbance, incidence rate of permanent nerve palsy, and recovery rate of abducens nerve palsy were 73.2 (57.1, 86.9)%, 971.17 (584.07, 1358.27) mL, 66.4 (32.4, 0.942)%, 16.0 (4.6, 31.1)%, and 70.6 (51.0, 87.7)%, respectively. Notably, the recovery rate of abducens nerve palsy post-radiotherapy was markedly higher than post-surgical treatment. The results of this meta-analysis underscore that radiotherapy is an effective and safe treatment modality for CSHs. Furthermore, the prognostic outcomes of radiotherapy demonstrated superiority over surgical intervention.