Role of Hypofractionated Stereotactic Radiotherapy for Primary Optic Nerve Sheath Meningioma

IF 2.4 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2023-10-03 DOI:10.1093/nop/npad060

İrem Koç, Sezin Yüce Sarı, Gözde Yazıcı, Yasemin Kapucu, Hayyam Kıratlı, Faruk Zorlu

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引用次数: 0

Abstract

Abstract Background Optic nerve sheath meningiomas (ONSM) are rare tumors potentially causing visual deficits. This study aims to report the anatomic and visual outcomes of patients with primary ONSM treated with hypofractionated stereotactic radiotherapy (HF-SRT). Methods Data of 36 patients treated with HF-SRT between 2008 and 2019 were retrospectively collected. The clinical target volume (CTV) was equal to the gross tumor volume and a 2 mm was added for the planning target volume. All responses other than progression were accepted as local control (LC). The VA grading was performed under 3 groups to provide an even distribution; 20/400 or worse, 20/40-20/400, and 20/40 or better. Results Median HF-SRT dose was 25 Gy and the median CTV was 1.94 cc. After a median of 106 months of follow-up, the tumor regressed in 23 (64%), was stable in 9 (25%), and progressed in 4 (11%) eyes. The overall rate of LC was 89% with 2-, 5-, 10-, and 15-year rate of 100%, 94%, 84%, and 84%, respectively. Treatment-related late toxicity rate was 11%. The VA was stable in 27 (75%) eyes, improved in 5 (14%) eyes, and worsened in 4 (11%) eyes, respectively, after HF-SRT. Female gender was the only independent predictor of an improved VA. Conclusions Hypofractionated stereotactic radiotherapy is a safe and satisfactory treatment option for primary ONSM without severe toxicity. It may be advisable to commence treatment before an established visual deficit of 20/400 or worse occurs, to make the most of the functional benefit.

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低分割立体定向放射治疗原发性视神经鞘脑膜瘤的作用

视神经鞘脑膜瘤(ONSM)是一种罕见的具有潜在视觉缺陷的肿瘤。本研究旨在报告原发性ONSM患者接受低分割立体定向放疗(HF-SRT)治疗的解剖和视觉结果。方法回顾性收集2008 ~ 2019年接受HF-SRT治疗的36例患者资料。临床靶体积(CTV)与肿瘤总体积相等，计划靶体积增加2mm。除进展外的所有反应均被接受为局部控制(LC)。为使VA分布均匀，将VA分为3组;20/400或更差，20/40-20/400,20/40或更好。结果中位HF-SRT剂量为25 Gy，中位CTV为1.94 cc。中位随访106个月后，肿瘤消退23例(64%)，稳定9例(25%)，进展4例(11%)。总LC率为89%，2年、5年、10年和15年的LC率分别为100%、94%、84%和84%。治疗相关的晚期毒性发生率为11%。HF-SRT后，27只(75%)眼的VA稳定，5只(14%)眼VA改善，4只(11%)眼VA恶化。结论低分割立体定向放疗对原发性ONSM是一种安全、满意的治疗选择，且无严重毒性。在视力下降到20/400或更差之前开始治疗是明智的，以使功能获益最大化。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving