Analysis of safety and efficacy of proton radiotherapy for optic nerve sheath meningioma.

IF 3.7 Q1 CLINICAL NEUROLOGY
Neuro-oncology advances Pub Date : 2024-09-21 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae160
Maximilian Y Deng, Sophie Rauh, Günes Anil, Jonathan W Lischalk, Laura Hahnemann, Tanja Eichkorn, Juliane Hörner-Rieber, Angela Paul, Elisabetta Sandrini, Philipp Hoegen-Sassmannshausen, Thomas Held, Sebastian Regnery, Lukas Bauer, Felix Sahm, Andreas von Deimling, Antje Wick, Wolfgang Wick, Christine Jungk, Sandro M Krieg, Klaus Herfarth, Jürgen Debus, Laila König
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引用次数: 0

Abstract

Background: Primary optic nerve sheath meningiomas (ONSMs) represent a group of benign tumors originating from the optic nerve sheath, typically causing painless, gradual onset monocular visual loss, which can result in blindness if left untreated. Radiation therapy represents an important treatment option for patients with ONSM, allowing for preservation and potential improvement in visual function. In particular, proton radiotherapy may enable a reduction of the side effects due to its physical advantage of an inverted dose profile with a steep dose gradient. The study investigates the visual acuity, local tumor control, and treatment-related toxicities following proton beam radiotherapy with a single institutional cohort comprising 32 patients treated for ONSM.

Methods: Patients with primary ONSM, either histologically (16/32) or radiologically confirmed (16/32), which were treated at the Department of Radiation Oncology at the University Hospital Heidelberg (Germany) were assessed in regard to their visual outcomes, treatment toxicity, and local tumor control following radiotherapy according to response assessment in neuro-oncology criteria.

Results: After a median follow-up time of 39.5 months, the 5-year local progression-free survival was estimated at 100%, with 84.4% of patients reporting improvement or stability in visual acuity during their last follow-up. Radiation-induced optic neuropathy (RION) was encountered in 9.4%.

Conclusions: Our study demonstrates proton beam therapy as a safe and effective treatment alternative in the therapeutic management of ONSMs. RION represents a rare but dreaded complication after treatment. Future head-to-head comparisons with photon radiotherapy in a prospective setting are required to demonstrate a potential, additional clinical benefit.

质子放射治疗视神经鞘脑膜瘤的安全性和有效性分析。
背景:原发性视神经鞘脑膜瘤(ONSMs)是一组起源于视神经鞘的良性肿瘤,通常会引起无痛性、渐进性的单眼视力下降,如果不及时治疗,可能会导致失明。放射治疗是 ONSM 患者的一种重要治疗选择,可以保护和改善患者的视功能。特别是质子放射治疗,由于其具有倒剂量曲线和陡峭剂量梯度的物理优势,可以减少副作用。该研究调查了质子束放疗后的视力、局部肿瘤控制和治疗相关毒性反应,研究对象是由 32 名 ONSM 患者组成的单一机构队列:方法:根据神经肿瘤学反应评估标准,对在海德堡大学医院(德国)放射肿瘤科接受治疗的原发性ONSM患者(组织学确诊(16/32)或放射学确诊(16/32))的视力结果、治疗毒性以及放疗后的局部肿瘤控制情况进行评估:中位随访时间为 39.5 个月,5 年局部无进展生存率估计为 100%,84.4% 的患者在最后一次随访中报告视力有所改善或稳定。9.4%的患者出现了放射诱导性视神经病变(RION):我们的研究表明,质子束疗法是治疗ONSMs的一种安全有效的替代疗法。RION是治疗后一种罕见但可怕的并发症。未来需要在前瞻性环境中与光子放疗进行头对头比较,以证明其潜在的额外临床益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
0.00%
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审稿时长
12 weeks
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