Management of cerebellopontine angle (CPA) meningiomas is challenging due to their proximity to critical neurovascular structures. Stereotactic radiosurgery (SRS) has been increasingly utilized for the management of individuals with CPA meningiomas; however, the comprehensive data on its effectiveness and safety profile are limited.

A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. The local control (LC), progression-free survival (PFS), serviceable hearing preservation (SHP), facial nerve (FN) deterioration, trigeminal nerve (TN) deterioration, and adverse radiation effects (ARE) pooled estimates following SRS were calculated using R software.

Thirteen studies, including 604 individuals with CPA meningioma, were included. The meta-analysis revealed a pooled LC rate of 98% (95% CI: 96–99%), 1-year PFS of 100% (95% CI: 100–100%), and 5-year PFS of 94% (95% CI: 81–100%) following SRS. The meta-analysis demonstrated a pooled SHP rate of 96% (95% CI: 86–100%). FN deterioration of 0% (95% CI: 0–2%), and TN deterioration of 1% (95% CI: 0–2%) with a pooled ARE rate of 1% (95% CI: 0–3%). The Meta-regression showed that greater prescribed doses and cochlear doses were correlated with lower SHP and higher ARE rates.

SRS provides a promising LC with functional outcomes concurrent with a favorable safety profile for CPA meningiomas. SRS should be considered as a primary option or as an adjunct to subtotal resection in CPA meningiomas.