Early improvements in vision after fractionated stereotactic radiotherapy for primary optic nerve sheath meningioma.
OBJECTIVE
To report on the efficacy and follow-up of 23 patients with primary optic nerve sheath meningioma (ONSM) with fractionated stereotactic conformal radiotherapy (SCRT).


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.
Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
Brigitta G
BG
Baumert
Salvador
S
Villà
Gabriela
G
Studer
René-Olivier
RO
Mirimanoff
J Bernard
JB
Davis
Klara
K
Landau
Nicolas
N
Ducrey
Jordi
J
Arruga
Philippe
P
Lambin
Alessia
A
Pica
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D008579:Meningioma / Q000532:radiotherapy*; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000532:radiotherapy*; D019574:Optic Nerve Neoplasms / Q000532:radiotherapy*; D020266:Radiotherapy, Conformal / Q000379:methods; D013238:Stereotaxic Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014787:Vision Tests; D014785:Vision, Ocular / Q000528:radiation effects*