Stereotactic fractionated radiotherapy in patients with optic nerve sheath meningioma.
OBJECTIVE
To evaluate the effectiveness of stereotactic fractionated radiotherapy (SFRT) in the treatment of optic nerve sheath meningioma (ONSM). METHODS AND MARERIALS: Between 1994 and 2000, a total of 39 patients with either primary (n = 15) or secondary (n = 24) ONSM were treated with SFRT and received a median total tumor dose of 54 Gy using 1.8 Gy/fraction.


RESULTS
The radiographic response to SFRT was documented in all patients as stable disease (no change) except for 1 patient with a partial response. After a median follow-up of 35.5 months, all patients with ONSM were alive without recurrence. The visual fields and visual acuity were improved in 6 of 15 and 1 of 16 examined eyes in patients with primary ONSM, respectively, and in 6 of 24 and 7 of 26 examined eyes in patients with secondary ONSM, respectively. Stable visual fields and visual acuity was observed in 8 of 14 and 15 of 16 patients with primary ONSM, respectively, and in 17 of 24 and 19 of 26 patients with secondary ONSM, respectively. Except for reversible alopecia and erythema, no other SFRT-related toxicity was observed.


CONCLUSIONS
SFRT represents a very effective and low-toxic treatment modality for ONSM. Despite a median follow-up of 3 years, this series of primary ONSM holds promise for future studies. It adds substantial evidence that SFRT may definitely become a standard treatment approach in selected cases of ONSM.
Becker
Gerd
G
Department of Radiation Oncology, University Hospital, Tübingen, Germany. Gerd.Becker@KaE.de
Jeremic
Branislav
B
Pitz
Susanne
S
Buchgeister
Markus
M
Wilhelm
Helmut
H
Schiefer
Ulrich
U
Paulsen
Frank
F
Zrenner
Eberhart
E
Bamberg
Michael
M
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D019574:Optic Nerve Neoplasms / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome