Document Detail


Multisession radiosurgery for optic nerve sheath meningiomas-an effective option: preliminary results of a single-center experience.
MedLine Citation:
PMID:  21971489     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Traditional treatment options for optic nerve sheath meningiomas (ONSMs) include observation, surgery, and radiotherapy, but to date none of these has become the clear treatment of choice.
OBJECTIVE: To evaluate the effectiveness and safety of multisession radiosurgery for ONSMs.
METHODS: From May 2004 to June 2008, 21 patients with ONSMs were treated by radiosurgery using the frameless CyberKnife system. Patient age ranged from 36 to 73 years (mean, 54 years). All patients were treated using multisession radiosurgery, with 5 fractions of 5 Gy each to a total dose of 25 Gy prescribed to the 75% to 85% isodose line. Patients were evaluated for tumor growth control and visual function.
RESULTS: The median pretreatment tumor volume was 2.8 mL (range, 0.3-23 mL). The mean follow-up was 30 months (range, 11-68 months). All patients tolerated treatment well, with only 1 patient in whom a mild optic neuropathy developed (which remitted after systemic steroid therapy). No other acute or late radiation-induced toxicities were observed. No patients showed ONSM progression on follow-up magnetic resonance imaging. Two patients (10%) had a partial response. No patients had worsening of visual function; visual function was stable in 65% and improved in 35% of patients.
CONCLUSION: Multisession radiosurgery for ONSMs was found to be safe and effective. The preliminary results from this study, in terms of growth control, visual function improvement, and toxicity, are quite promising. Further investigations are warranted.
ABBREVIATIONS: fSRT: fractionated stereotactic radiation therapymSRS: multisession radiosurgeryONSM: optic nerve sheath meningioma.
Authors:
Marcello Marchetti; Stefania Bianchi; Ida Milanesi; Achille Bergantin; Livia Bianchi; Giovanni Broggi; Laura Fariselli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  69     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1116-23     Citation Subset:  IM    
Affiliation:
*Department of Neurosurgery, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy ‡Faculty of Medicine, Università degli Studi di Milano, Milano, Italy §Neuro-ophthalmology Unit, Department of Ophthalmology, Scientific Institute S. Raffaele, University Vita-Salute, Milano, Italy ¶CyberKnife Center, Centro Diagnostico Italiano, Milano, Italy ‖Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy.
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