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<p>Cerebral cavernous malformations (CCMs) are clusters of dilated, thin-walled vascular channels that pose significant neurological risks, particularly in pediatric patients. While stereotactic radiosurgery (SRS) has been explored as a non-invasive treatment modality, its safety and efficacy in children remain incompletely defined. We conducted a systematic review and meta-analysis of single-arm proportions after SRS for pediatric CCMs. PubMed and the Cochrane Library were searched; four retrospective cohort studies met inclusion criteria. Random-effects pooled proportions were calculated for key outcomes. Post-SRS seizure proportion (three studies; <i>n</i> = 73) was 0.23 (95% CI, 0.11–0.37; I<sup>2</sup> = 23.7%; <i>p</i> = 0.27). A lesion-volume decrease was observed in 0.34 (0.18–0.67; I<sup>2</sup> = 82.1%; <i>p</i> = 0.0037). Post-SRS hemorrhage proportion (four studies) was 0.22 (0.09–0.52; I<sup>2</sup> = 76.1%; <i>p</i> = 0.0058). Adverse radiation effects (AREs) were uncommon but variably reported. Findings suggest that radiosurgery may provide benefit in selected pediatric CCMs, though small sample sizes and study heterogeneity warrant cautious interpretation.</p>

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Stereotactic radiosurgery in the treatment of pediatric cerebral cavernous malformations: a systematic review and meta-analysis of outcomes and safety

  • 期刊论文

  • 发表日期：

    2025年10月21日

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  • Bibhas Amatya,
  • Ritvik Pulya,
  • Julian Gendreau,
  • Mickey E. Abraham

摘要

Cerebral cavernous malformations (CCMs) are clusters of dilated, thin-walled vascular channels that pose significant neurological risks, particularly in pediatric patients. While stereotactic radiosurgery (SRS) has been explored as a non-invasive treatment modality, its safety and efficacy in children remain incompletely defined. We conducted a systematic review and meta-analysis of single-arm proportions after SRS for pediatric CCMs. PubMed and the Cochrane Library were searched; four retrospective cohort studies met inclusion criteria. Random-effects pooled proportions were calculated for key outcomes. Post-SRS seizure proportion (three studies; n = 73) was 0.23 (95% CI, 0.11–0.37; I2 = 23.7%; p = 0.27). A lesion-volume decrease was observed in 0.34 (0.18–0.67; I2 = 82.1%; p = 0.0037). Post-SRS hemorrhage proportion (four studies) was 0.22 (0.09–0.52; I2 = 76.1%; p = 0.0058). Adverse radiation effects (AREs) were uncommon but variably reported. Findings suggest that radiosurgery may provide benefit in selected pediatric CCMs, though small sample sizes and study heterogeneity warrant cautious interpretation.