Abstract
BACKGROUND: Hypothalamic hamartomas (HHs) are congenital, non-neoplastic tumors originating from the hypothalamic region. While surgical resection remains the standard treatment, it is associated with substantial morbidity, leading to the exploration of minimally invasive approaches such as radiofrequency thermocoagulation (RFTC), laser interstitial thermal therapy (LiTT), and stereotactic radiosurgery (SRS). This systematic review and meta-analysis evaluate the efficacy and safety of SRS in managing HHs, with a focus on seizure control, endocrine function, and treatment-related complications. METHODS: A comprehensive literature search was conducted on December 6, 2024, using PubMed, Embase, Scopus, and Web of Science. Studies that evaluated the role of SRS in HH patients were included. The R program was used to calculate the pooled estimates. RESULTS: Seven studies with 152 HH patients were included. The meta-analysis revealed a pooled post-SRS seizure improvement rate of 77% (95% CI: 61%-91%) and a seizure-free status rate of 48% (95% CI: 19%-78%). In addition, the meta-analysis showed a pooled good outcome, Engel I/II, rate of 67% (95% CI: 48%-84%), and a pooled adverse radiation effect (ARE) rate of 0% (95% CI: 0%-1%). CONCLUSION: SRS provides favorable seizure control and a promising safety profile for managing patients with HH. CLINICAL TRIAL NUMBER: Not applicable.