Background: Stereotactic radiation techniques are increasingly used in the management of glioma, particularly for recurrent or progressive disease. While most studies emphasize traditional oncologic outcomes such as survival and tumor control, the impact of treatment on patient-centered outcomes, including functional status and health-related quality of life (HRQoL), remains less well characterized. This study aimed to systematically synthesize evidence on functional and HRQoL outcomes following stereotactic radiation for glioma.
Methods: A systematic literature search of PubMed, Embase, and Google Scholar was conducted in accordance with PRISMA guidelines, with the final search performed in January 2026. English-language studies reporting functional or HRQoL outcomes following Stereotactic Radiosurgery or Stereotactic Radiotherapy for glioma were included. The primary outcome was change or stability in functional status, most commonly measured using the Karnofsky Performance Status. Secondary outcomes included HRQoL measures such as the EORTC QLQ-C30 family of instruments and the SF-36. Risk of bias was assessed using the ROBINS-I tool. Random-effects meta-analysis was performed where sufficient data were available, with subgroup analyses comparing newly diagnosed versus recurrent tumors and stereotactic radiosurgery versus stereotactic radiotherapy.
Results: The search identified 1,562 records, of which 310 were duplicates, leaving 1,252 articles for screening. Following full-text review, 41 studies met inclusion criteria, representing 5,234 patients. Substantial heterogeneity was observed in study design, treatment regimens, and outcome reporting, and many studies included small cohorts. Functional outcomes were most frequently assessed using the Karnofsky Performance Status (n=30), followed by the EORTC QLQ-C30 family (n=9) and the SF-36 (n=2). Across studies, over 90% of patients demonstrated stable or unchanged functional status after treatment. HRQoL outcomes were similarly reported as largely stable.
Conclusion: Available evidence suggests stereotactic radiation may preserve functional status and HRQoL in appropriately selected glioma patients. However, existing studies are heterogeneous and frequently limited by small sample sizes and observational designs. Standardized HRQoL reporting will be essential for improving comparability in future glioma research.
Methods: A systematic literature search of PubMed, Embase, and Google Scholar was conducted in accordance with PRISMA guidelines, with the final search performed in January 2026. English-language studies reporting functional or HRQoL outcomes following Stereotactic Radiosurgery or Stereotactic Radiotherapy for glioma were included. The primary outcome was change or stability in functional status, most commonly measured using the Karnofsky Performance Status. Secondary outcomes included HRQoL measures such as the EORTC QLQ-C30 family of instruments and the SF-36. Risk of bias was assessed using the ROBINS-I tool. Random-effects meta-analysis was performed where sufficient data were available, with subgroup analyses comparing newly diagnosed versus recurrent tumors and stereotactic radiosurgery versus stereotactic radiotherapy.
Results: The search identified 1,562 records, of which 310 were duplicates, leaving 1,252 articles for screening. Following full-text review, 41 studies met inclusion criteria, representing 5,234 patients. Substantial heterogeneity was observed in study design, treatment regimens, and outcome reporting, and many studies included small cohorts. Functional outcomes were most frequently assessed using the Karnofsky Performance Status (n=30), followed by the EORTC QLQ-C30 family (n=9) and the SF-36 (n=2). Across studies, over 90% of patients demonstrated stable or unchanged functional status after treatment. HRQoL outcomes were similarly reported as largely stable.
Conclusion: Available evidence suggests stereotactic radiation may preserve functional status and HRQoL in appropriately selected glioma patients. However, existing studies are heterogeneous and frequently limited by small sample sizes and observational designs. Standardized HRQoL reporting will be essential for improving comparability in future glioma research.