Abstract Details

Title Single-session versus Multi-session Linear Accelerator-based Stereotactic Radiosurgery for Intracranial Meningiomas: A Systematic Review, Meta-Analysis, and Cumulative Meta-analysis

Topic Neuro-oncology

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-001

Objective

To compare tumor volume, functional status, adverse effects, and progression-free survival in meningioma patients treated with single-session versus multi-session radiosurgery.

Background

Meningiomas comprise one-third of primary intracranial tumors. Stereotactic radiosurgery is a non-surgical radiotherapy technique that delivers focused beams of high-dose radiation while sparing healthy tissue.

Design/Methods

Relevant articles were retrieved from four databases covering the period from 1980 to 2025. PRISMA guidelines were followed; 29 studies comprising a cohort of 1,517 patients (SS-SRS: 1,040 , MS-SRS: 477 patients ) were included. All analysis were conducted using “meta” package on R version 4.3.3.

Results Among 1,517 patients with available outcome data, tumor volume progression was similar for single-session (SS-SRS, 13% [95% CI: 7–23%]) and multi-session SRS (MS-SRS, 10% [5–18%]), p=0.5751. We didn’t observe any statistically significant differences in tumor volume decrease between the two subgroups (SS-SRS: 28% [19–39%]; MS-SRS: 25% [16–37%], p=0.6608). Tumor volume stability was also non-significant: (SS-SRS: 52% [34–69%]; MS-SRS: 73% [59–83%], p=0.0658). Functional outcomes showed no subgroup differences: improvement (SS-SRS: 38% [25–53%]; MS-SRS: 36% [23–51%]), worsening ( SS-SRS: 9% [5–15%]; MS-SRS: 7% [4–10%]), and stability (SS-SRS: 42% [24–65%]; MS-SRS: 63% [53–72%], P = 0.1029). Tumor control rates were high at 5-years for SS-SRS (SS-SRS: 87% [76–93%]; MS-SRS: 82% [54–95%]).

Edema was the most frequently reported adverse effect, occurring in 68 patients treated with single-session radiosurgery, compared to 5 patients in the multi-session group. Heterogeneity was substantial across most analyses. Cumulative meta-analysis revealed stable effect estimates over time, with narrowing confidence intervals in recent studies. Most studies fall within the expected range of sampling variability, with a center clustering of data, and the data was symmetrically distributed; which suggests low risk of publication bias.

Conclusions SS-SRS and MS-SRS yield comparable tumor volume and functional outcomes, but MS-SRS may offer higher volume and functional status stability. Both are effective, with selection guided by clinical context

Authors/Disclosures
Bashar Abualsebaa, MD PRESENTER	Mr. Abualsebaa has nothing to disclose.
Rama F. Al-Ammouri II, MD	Ms. Al-Ammouri has nothing to disclose.
Bara M. Hammadeh	Mr. Hammadeh has nothing to disclose.
Joud J. Ayad, MD	Mrs. Ayad has nothing to disclose.
Zaid M. Muhanna	Dr. Muhanna has nothing to disclose.
Alzahra'a M. Al matairi II, Medical student	Miss Al matairi has nothing to disclose.
Salma Nofal, MD	Miss Nofal has nothing to disclose.
Ayah Abdulgadir	Dr. Abdulgadir has nothing to disclose.
Tariq Al-Saadi, MD	Dr. Al-Saadi has nothing to disclose.

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