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Background <p>Central nervous system lymphomas (CNSL) are aggressive and rare malignancies that are associated with a poor prognosis and limited treatment options. While high-dose methotrexate (HD-MTX) and whole-brain radiotherapy (WBRT) are primary options, they are correlated with recurrence and neurotoxicity. Stereotactic radiosurgery (SRS) has emerged as a potential targeted option; however, its effectiveness in CNSL remains largely unexplored. This study aimed to evaluate the role of SRS in CNSLs.</p> Methods <p>A systematic search was conducted in PubMed, Embase, Scopus, and Web of Science. Studies reporting local control (LC), progression-free survival (PFS), overall survival (OS), distant brain failure (DBF), and adverse radiation effects (ARE) were included.</p> Results <p>Sixteen studies involving 321 patients and 462 lesions were analyzed. The pooled LC was 97% (95% CI: 94%–100%), and the DBF rate was 58% (95% CI: 43%–72%). The PFS at 6, 12, and 24 months was 75% (95% CI: 67%–83%), 54% (95% CI: 44%–63%), and 29% (95% CI: 13%–48%), while the OS was 90% (95% CI: 78%–98%), 73% (95% CI: 56%–88%), and 42% (95% CI: 26%–59%). The pooled ARE rate was 7% (95% CI: 4%–11%). Human immunodeficiency virus (HIV)-positive status and larger tumor size were associated with less favorable outcomes.</p> Conclusion <p>SRS is associated with promising clinical and radiologic outcomes and low ARE rates in patients with CNSL, serving as a complementary or salvage option.</p>

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Stereotactic radiosurgery for central nervous system lymphoma: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月14日

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  • Bardia Hajikarimloo,
  • Ibrahim Mohammadzadeh,
  • Salem M. Tos,
  • Ali Mortezaei,
  • Mohammadamin Sabbagh Alvani,
  • Alireza Kooshki,
  • Mohammad Amin Habibi

摘要

Background

Central nervous system lymphomas (CNSL) are aggressive and rare malignancies that are associated with a poor prognosis and limited treatment options. While high-dose methotrexate (HD-MTX) and whole-brain radiotherapy (WBRT) are primary options, they are correlated with recurrence and neurotoxicity. Stereotactic radiosurgery (SRS) has emerged as a potential targeted option; however, its effectiveness in CNSL remains largely unexplored. This study aimed to evaluate the role of SRS in CNSLs.

Methods

A systematic search was conducted in PubMed, Embase, Scopus, and Web of Science. Studies reporting local control (LC), progression-free survival (PFS), overall survival (OS), distant brain failure (DBF), and adverse radiation effects (ARE) were included.

Results

Sixteen studies involving 321 patients and 462 lesions were analyzed. The pooled LC was 97% (95% CI: 94%–100%), and the DBF rate was 58% (95% CI: 43%–72%). The PFS at 6, 12, and 24 months was 75% (95% CI: 67%–83%), 54% (95% CI: 44%–63%), and 29% (95% CI: 13%–48%), while the OS was 90% (95% CI: 78%–98%), 73% (95% CI: 56%–88%), and 42% (95% CI: 26%–59%). The pooled ARE rate was 7% (95% CI: 4%–11%). Human immunodeficiency virus (HIV)-positive status and larger tumor size were associated with less favorable outcomes.

Conclusion

SRS is associated with promising clinical and radiologic outcomes and low ARE rates in patients with CNSL, serving as a complementary or salvage option.