title: Primary radiotherapy in progressive optic nerve sheath meningiomas: a long-term follow-up study.
abstract: BACKGROUND/AIMS To report the outcome of primary radiotherapy in patients with progressive optic nerve sheath meningioma (ONSM). METHODS The clinical records of all patients were reviewed in a retrospective, observational, multicentre study. RESULTS Thirty-four consecutive patients were included. Twenty-six women and eight men received conventional or stereotactic fractionated radiotherapy, and were followed for a median 58 (range 51-156) months. Fourteen eyes (41%) showed improved visual acuity of at least two lines on the Snellen chart. In 17 (50%) eyes, the vision stabilised, while deterioration was noted in three eyes (9%). The visual outcome was not associated with age at the time of radiotherapy (p=0.83), sex (p=0.43), visual acuity at the time of presentation (p=0.22) or type of radiotherapy (p=0.35). Optic disc swelling was associated with improved visual acuity (p<0.01) and 4/11 patients with optic atrophy also showed improvement. Long-term complications were dry eyes in five patients, cataracts in three, and mild radiation retinopathy in four. CONCLUSION Primary radiotherapy for patients with ONSM is associated with long-term improvement of visual acuity and few adverse effects.
authors.affiliation: Orbital Center/Department of Ophthalmology, University of Amsterdam, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands. p.saeed@amc.uva.nl
authors.forename: Peerooz
authors.initials: P
authors.lastname: Saeed
authors.forename: Leo
authors.initials: L
authors.lastname: Blank
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
authors.forename: John G
authors.initials: JG
authors.lastname: Wolbers
authors.forename: Peter J C M
authors.initials: PJ
authors.lastname: Nowak
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.forename: Ezekiel
authors.initials: E
authors.lastname: Weis
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
authors.forename: Jack
authors.initials: J
authors.lastname: Rootman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D015352:Dry Eye Syndromes / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000150:complications / Q000532:radiotherapy*; D008875:Middle Aged; D019574:Optic Nerve Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011379:Prognosis; D011832:Radiation Injuries / Q000209:etiology; D012164:Retinal Diseases / Q000209:etiology; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology; D014792:Visual Acuity; D014794:Visual Fields