Preliminary visual outcomes after three-dimensional conformal radiation therapy for optic nerve sheath meningioma.
OBJECTIVE
We assessed visual outcomes, local control, and toxicity associated with three-dimensional conformal radiation therapy (3D-CRT) for primary optic nerve sheath meningiomas (ONSM).


METHODS
Twenty-three patients diagnosed with ONSM were evaluated at the University of Michigan between 1986 and 2001. Fourteen patients were treated with 3D-CRT. Detailed pre- and postradiation treatment ophthalmologic examinations and MRIs were performed on all patients. Clinically significant visual acuity change was defined as a >or=three line change on the Snellen chart. Mean deviation change of >or=three decibels was defined as a clinically significant visual field change. Radiographic progression was defined as any increase in size on MRI. Acute and late toxicity was scored according to RTOG criteria.


RESULTS
Median follow-up was 51.3 months. Five patients had a clinically significant improvement in visual acuity. Seven had stable acuity, and only 2 worsened. Nine patients had clinically significant visual field improvement. One patient developed early radiation retinopathy, 1 experienced orbital pain, 1 developed dry eye, and 2 developed iritis. No patient has required additional treatment, and none have demonstrated radiographic progression.


CONCLUSIONS
3D-CRT is effective in controlling tumor growth while improving or preserving vision in most patients with optic nerve sheath meningiomas.
Narayan
Samir
S
Department of Radiation Oncology, University of Michigan Health Care System, Ann Arbor, MI 48109, USA. narayan@umich.edu
Cornblath
Wayne T
WT
Sandler
Howard M
HM
Elner
Victor
V
Hayman
James A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy; D008579:Meningioma / Q000532:radiotherapy*; D008875:Middle Aged; D019574:Optic Nerve Neoplasms / Q000532:radiotherapy*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000532:radiotherapy*; D014792:Visual Acuity