Efficacy of intensity-modulated radiation therapy for optic nerve sheath meningioma

Abstract

Purpose The present study examined the efficacy and complications associated with intensity-modulated radiation therapy (IMRT) for optic nerve sheath meningioma (ONSM) in 15 cases and compared visual function before and after treatment. Methods Consecutively diagnosed patients with ONSM treated with IMRT were evaluated from 2012 to 2017. We categorized ONSM with three growth patterns (diffuse, fusiform, or globular). Visual acuity, visual fields, and optic disc findings were assessed before and after IMRT. Ocular and systemic complications were evaluated during and after treatment. Results The 15 patients selected for analysis ranged in age from 33 to 77 years. Post-treatment observation periods were 8 to 57 months. After IMRT, tumor enlargement was not detected in any eyes, and tumor reduction was seen in 2 eyes. At final posttreatment follow-up, eyes with fusiform and globular growth maintained better visual acuity compared with pre-treatment, whereas 2 of 5 eyes with diffuse growth showed reduced vision. Five eyes with no apparent optic disc abnormality maintained better visual acuity compared with pre-treatment, whereas 8 of 10 eyes with disc edema and atrophy remained stable or showed reduced vision. Improvements were seen in all 5 eyes with optic discs negative for pre-treatment abnormalities. Final posttreatment visual field abnormalities improved in 11 eyes. All adverse events identified during IMRT improved rapidly during the treatment period. Conclusion IMRT for the treatment of ONSM achieved improvement and preserved visual function. In particular, early treatment with IMRT before the appearance of optic disc abnormalities can be more effective for improving visual function.

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

“…The size of meningioma lesions after radiotherapy is usually described as stable or subtly regressive [35][36][37]. Likewise, none of our patients presented progression in tumor size during the short-term follow-up, but long-term outcomes remain to be evaluated.…”

Prognostic Factors for Functional Outcome of Patients with Optic Nerve Sheath Meningiomas Treated with Stereotactic Radiotherapy–Evaluation of Own and Meta-Analysis of Published Data

“…Additionally, we reviewed the published data on fractionated SRT of ONSM for the study time period between 2010 and 2019 [5,[15][16][17][18][19][20][21][22][23][24][25][26][27]. All data were pooled together and dichotomized as mentioned above.…”

“…However, extended long-term follow up of more than 10 years has not existed up to now [24]. Nevertheless, taking into account the potential local tumor progress risk after microsurgery of 17.8%, primary stereotactic radiotherapy seems to be the best tumor control option for meningiomas of this localization [26].…”

“…However, especially at sites nearby or with involvement of critical structures like the optic nerve, the brainstem and in the course of cranial nerves, microsurgical resection has low potential of functional improvement [1][2][3]31]. Taking into consideration the low morbidity profile of fSRT in the treatment of ONSM in our trial as well in other trials, we propagate an early treatment start [4,5,7,8,[15][16][17][18][20][21][22][23][24][25][26]32]. However, in very young individuals with a long life expectation it is unknown if fSRT could prevent them from deterioration of their ophthalmic status to the end of their life.…”

Estudo dos resultados do tratamento com radioterapia do meningioma da bainha do nervo óptico: revisão sistemática e metanálise

“…As definições de controle tumoral podem também ser muito diferentes, o que pode impactar na descrição dos resultados observados na literatura. O controle tumoral do MBNO foi definido pela maioria dos autores como ausência de evidência de progressão estrutural, com base nos exames de imagem durante os diversos períodos de acompanhamento (BECKER et al, 2002;ECKERT et al, 2019;LIU et al, 2002;NARAYAN et al, 2003;SASANO et al, 2019;SITATHANEE et al, 2006).…”