Early improvements in vision after fractionated stereotactic radiotherapy for primary optic nerve sheath meningioma

Radiother Oncol. 2004 Aug;72(2):169-74. doi: 10.1016/j.radonc.2004.04.008.

Abstract

Background and purpose: To report on the efficacy and follow-up of 23 patients with primary optic nerve sheath meningioma (ONSM) with fractionated stereotactic conformal radiotherapy (SCRT).

Patients and methods: Between 1996 and 2003, 23 patients ( = 23 eyes) with ONSM were treated. Indications for primary stereotactic radiotherapy were tumour progression documented by imaging or symptoms (loss of vision, pain). All patients received SCRT with a median dose of 50.4Gy in 6 weeks.

Results: After a median follow-up of 20 months (1-68 months) a 95% (21 of 22) visual control was seen: vision improved in 16 patients and remained stable in 5. For 13/16 patients improvement was documented already within 1-3 months after SCRT. Vision became worse in one patient. An improvement of pain was observed after radiotherapy in 6 patients as well as of proptosis in 1 patient. For 1 patient pain was persistent after SCRT. In one patient 4 years after SCRT a radiation retinitis and vitreous haemorrhage was seen.

Conclusions: Fractionated stereotactic radiotherapy improves vision, often shortly after treatment, and is thus a viable treatment option for this tumour entity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Dose Fractionation, Radiation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningeal Neoplasms / radiotherapy*
  • Meningioma / radiotherapy*
  • Middle Aged
  • Nerve Sheath Neoplasms / radiotherapy*
  • Optic Nerve Neoplasms / radiotherapy*
  • Radiotherapy, Conformal* / methods
  • Stereotaxic Techniques
  • Time Factors
  • Treatment Outcome
  • Vision Tests
  • Vision, Ocular / radiation effects*