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--- intracranial_solitary_fibrous_tumor [2025/07/03 06:38] – [Systematic review and meta‑analysis] administrador
+++ intracranial_solitary_fibrous_tumor [2025/07/03 06:42] (current) – administrador
@@ Line 10: / Line 10: @@
 ===== Treatment =====
-  * **Gross Total Resection (GTR)** is the primary treatment goal.
-  * **Postoperative Radiotherapy (PORT)**:
-    * Recommended especially for Grade II/III or subtotal resection.
-    * Improves local control and progression-free survival.
-  * **Recurrence** and **extracranial metastases** are possible, especially in higher grades.
-===== Systematic review and meta‑analysis =====
+[[Intracranial solitary fibrous tumor treatment]]
-In a [[systematic review]] and [[metaanalysis]]
-Na et al.
-from the Hanyang University, Seoul; Kangnam Sacred Heart Hospital, Seoul; Chung‑Ang University, Seoul & Gwangmyeong; Dongsan Medical Center, Daegu
-published in the Journal [[Scientific Reports]] (Nature)
-to determine whether postoperative radiotherapy (PORT) after [[gross total resection]] (GTR) of intracranial [[solitary fibrous tumor]]s (SFT) improves [[Progression-Free Survival]] (PFS), [[overall survival]] (OS), and [[metastasis‑free survival]] (MFS).
-PORT significantly improved both PFS and OS after GTR; no effect on MFS. [[Author]]s suggest PORT should be considered for all intracranial SFT patients post‑GTR
-((Na MK, Choi KS, Lim TH, Shin H, Lee J, Lee H, Kim W, Kim JG, Cho Y, Ahn C, Kim JH, Jang BH, Namgung M, Kwon SM. A [[systematic review]] and [[meta-analysis]] on the [[efficacy]] of [[postoperative radiotherapy]] after [[gross total resection]] of [[intracranial solitary fibrous tumor]]s. Sci Rep. 2025 Jul 2;15(1):23368. doi: 10.1038/s41598-025-02170-0. PMID: 40603922.)).
-=== Critical appraisal ===
-* **Scope & relevance** – Addresses a clinically important and under‑consensus management question: role of radiotherapy after resection of rare intracranial SFT.
-* **Methodology** – Follows PRISMA guidelines; searched Medline, Embase, Cochrane. Included 12 studies totalling 419 patients. Meta‑analysis of hazard ratios for survival. However, heterogeneity among included studies—some retrospective, variable PORT protocols (dose, timing), inconsistent follow‑up durations.
-* **Statistical strength** – Pooled HRs show clear benefit in PFS and OS. Subgroup analysis for grades 2–3 supports findings. Yet, no mention of publication‑bias assessments (e.g., funnel‑plot or Egger’s test) or sensitivity analyses excluding poor‑quality studies.
-* **Limitations** – Lack of detailed quality scoring for individual studies; variation in grading systems over time (hemangiopericytoma terminology overlap); absence of toxicity or quality‑of‑life data post‑PORT; no randomized controlled trials included.
-* **Clinical impact** – Suggests consistent survival advantage favoring PORT, but generalizability is limited by retrospective data and tumor rarity.
-=== Final Verdict ===
-While methodologically sound and compelling in its aggregate survival benefit findings, the evidence remains moderate due to heterogeneity and retrospective design. More robust prospective data are needed, but in high‑grade or borderline cases, PORT can be strongly considered.
-**Rating**:: 7.5 / 10
-=== Takeaway for practicing neurosurgeon ===
-After [[gross total resection]] of [[intracranial solitary fibrous tumor]]s—especially [[WHO]] grade 2 or 3—[[adjuvant]] [[radiotherapy]] appears to provide meaningful improvements in both progression‑free and [[overall survival]]. Given the [[retrospective]] evidence, surgeons and neuro‑oncologists should include PORT in multidisciplinary discussions and patient counseling.
-**Bottom line**:: In the absence of randomized [[evidence]], PORT is a reasonable addition to surgery for intracranial SFT to extend [[survival]].
-**Corresponding author’s email**:: [[kwonsaemin@hanmail.net]]