Effectiveness and Safety of Robotic Radiosurgery for Optic Nerve Sheath Meningiomas: A Single Institution Series

Abstract

The role of robotic radiosurgery (RRS) in the treatment of optic nerve sheath meningiomas (ONSM) remains controversial and it is only performed in specialized institutions due to tight dose constraints. We evaluated the effectiveness and safety of RRS in the management of ONSM. Twenty-five patients with 27 ONSM lesions who underwent RRS using the Cyberknife (CK) system were retrospectively analyzed (median age, 47.9 years; 84.0% women). Multisession RRS was used with 4–5 fractions with a cumulative dose of 20.0–25.0 Gy in 84.0% of patients and a single fraction at a dose of 14.0–15.0 Gy in 16% of patients. Prior to RRS, seven (28%) patients experienced blindness on the lesion side. In those patients with preserved vision prior to radiosurgery, the visual acuity remained the same in 90.0% and improved in 10.0% of the patients. Overall local tumor control was 96.0% (mean follow-up period; 37.4 ± 27.2 months). Neither patient age, previous surgery, or the period from the initial diagnosis to RRS showed a dependency on visual acuity before or after radiosurgery. RRS is a safe and effective treatment for the management of ONSM. Hypofractionation of radiosurgery in patients with preserved vision before CK treatment results in stable or improved vision.

68Ga-DOTATOC-PET/MRI—A Secure One-Stop Shop Imaging Tool for Robotic Radiosurgery Treatment Planning in Patients with Optic Nerve Sheath Meningioma

“…Radiosurgery has increasingly been applied to ONSM and offers a similar local control with only a few side effects in comparison to other irradiation techniques, as shown in our previous publication [20]. Here, we focus on the feasibility of 68Ga-DOTATOC PET/MRI in radiosurgical treatment of ONSM.…”

“…A total of 10 ONSM in 8 patients who underwent 68Ga-DOTATOC-PET/MRI before RRS were identified. These patients were part of the series that was recently published to assess local control [20].…”

Evaluating the Efficacy and Safety of CyberKnife for Meningiomas: A Systematic Review

“…Analyzing the 21 studies provided, several key themes emerge regarding using CyberKnife in managing meningiomas [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”