Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1116-1122 |
| Number of pages | 7 |
| Journal | Neurosurgery |
| Volume | 69 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 2011 |
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Keywords
- CyberKnife
- Optic nerve sheath meningiomas
- Radiosurgery
- Radiotherapy
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Multisession radiosurgery for optic nerve sheath meningiomas-An effective option : Preliminary results of a single-center experience. / Marchetti, Marcello; Bianchi, Stefania; Milanesi, Ida; Bergantin, Achille; Bianchi, Livia; Broggi, Giovanni; Fariselli, Laura.
In: Neurosurgery, Vol. 69, No. 5, 11.2011, p. 1116-1122.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multisession radiosurgery for optic nerve sheath meningiomas-An effective option
T2 - Preliminary results of a single-center experience
AU - Marchetti, Marcello
AU - Bianchi, Stefania
AU - Milanesi, Ida
AU - Bergantin, Achille
AU - Bianchi, Livia
AU - Broggi, Giovanni
AU - Fariselli, Laura
PY - 2011/11
Y1 - 2011/11
N2 - 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.
AB - 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.
KW - CyberKnife
KW - Optic nerve sheath meningiomas
KW - Radiosurgery
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=80053633607&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053633607&partnerID=8YFLogxK
U2 - 10.1227/NEU.0b013e31822932fe
DO - 10.1227/NEU.0b013e31822932fe
M3 - Article
VL - 69
SP - 1116
EP - 1122
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 5
ER -