title: Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors.
abstract: To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior skull base meningiomas and 55 patients treated with FSRT for pituitary adenomas between January 1999 and December 2009 with at least 2 years follow-up were included. Patients were followed up prospectively with magnetic resonance imaging scans, visual acuity and visual field examinations. RION was found in four (10%) patients with anterior skull base meningiomas and seven patients (13%) with pituitary adenomas. The five-year actuarial freedom from 25% RION visual field loss was 94% following FSRT. Actuarial 2-, 5- and 10-year tumor control rates were 100, 88.4 and 64.5% for anterior skull base meningiomas and 100, 98.2 and 94.9% for pituitary adenomas, respectively. Patients with an impaired visual field function pre-FSRT were more likely to experience worsened function (p = 0.016). We found that RION, was a relatively uncommon event, in a large prospective cohort of patients that were systematically monitored following FSRT of benign anterior skull base tumors. Long term tumor control was favorable, especially for pituitary adenomas.
authors: Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark, arnar.astradsson@gmail.com.
authors: Arnar
authors: A
authors: Astradsson
authors: Anne Katrine
authors: AK
authors: Wiencke
authors: Per
authors: P
authors: Munck af Rosenschold
authors: Svend-Aage
authors: SA
authors: Engelholm
authors: Lars
authors: L
authors: Ohlhues
authors: Henrik
authors: H
authors: Roed
authors: Marianne
authors: M
authors: Juhler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000209:etiology*; D011183:Postoperative Complications / Q000503:physiopathology*; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D014795:Visual Pathways / Q000473:pathology