Multisession Radiosurgery for Sellar and Parasellar Benign Meningiomas: Long-term Tumor Growth Control and Visual Outcome

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Concern about radiation-induced optic neuropathy (RION) has governed recent thinking about the role of radiation therapy in the treatment of meningiomas involving the anterior optic pathways. Despite this concern, during the last few years, the use of radiosurgery for such lesions has increased steadily.

OBJECTIVE: To define both the tumor control rate and the risk of RION over a long-term follow-up period in a large cohort of patients treated with multisession radiosurgery.

METHODS: The local control and visual outcome of 143 patients who underwent multisession radiosurgery (mRS) were evaluated. Neurological outcome was also analyzed. The data for the present study were obtained from a prospectively maintained database.

RESULTS: The mean follow-up was 44 months (range, 12-113 months). All patients underwent mRS. The median prescription dose was 25 Gy delivered in 3 to 5 fractions. The prescription isodose, which typically encompassed at least 95% of the tumor, ranged from 65% to 86% (median, 80%). The mean tumor volume was 11.0 cm (range, 0.1-126.3 cm; median, 8 cm). The progression-free survival at 3, 5, and 8 years was 100%, 93%, and 90%, respectively. Compared with baseline, visual function improved in 36% of patients, whereas 7.4% experienced a worsening in visual function (5.1% excluding the patients with progressive disease).

CONCLUSION: Good local control rate and a low risk of RION indicate that mRS is a safe and effective treatment option in cases of large meningiomas.

Original languageEnglish
Pages (from-to)638-46
Number of pages9
JournalNeurosurgery
Volume78
Issue number5
DOIs
Publication statusPublished - May 2016

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Radiosurgery
Meningioma
Optic Nerve Diseases
Growth
Radiation
Neoplasms
Prescriptions
Tumor Burden
Disease-Free Survival
Radiotherapy
Databases
Therapeutics

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningioma
  • Middle Aged
  • Optic Nerve Diseases
  • Pituitary Neoplasms
  • Postoperative Complications
  • Radiation Dosage
  • Radiation Injuries
  • Radiosurgery
  • Retrospective Studies
  • Sella Turcica
  • Treatment Outcome
  • Vision, Ocular
  • Young Adult
  • Journal Article

Cite this

@article{635c2662d87241d28c8d35fa2350f96b,
title = "Multisession Radiosurgery for Sellar and Parasellar Benign Meningiomas: Long-term Tumor Growth Control and Visual Outcome",
abstract = "BACKGROUND: Concern about radiation-induced optic neuropathy (RION) has governed recent thinking about the role of radiation therapy in the treatment of meningiomas involving the anterior optic pathways. Despite this concern, during the last few years, the use of radiosurgery for such lesions has increased steadily.OBJECTIVE: To define both the tumor control rate and the risk of RION over a long-term follow-up period in a large cohort of patients treated with multisession radiosurgery.METHODS: The local control and visual outcome of 143 patients who underwent multisession radiosurgery (mRS) were evaluated. Neurological outcome was also analyzed. The data for the present study were obtained from a prospectively maintained database.RESULTS: The mean follow-up was 44 months (range, 12-113 months). All patients underwent mRS. The median prescription dose was 25 Gy delivered in 3 to 5 fractions. The prescription isodose, which typically encompassed at least 95{\%} of the tumor, ranged from 65{\%} to 86{\%} (median, 80{\%}). The mean tumor volume was 11.0 cm (range, 0.1-126.3 cm; median, 8 cm). The progression-free survival at 3, 5, and 8 years was 100{\%}, 93{\%}, and 90{\%}, respectively. Compared with baseline, visual function improved in 36{\%} of patients, whereas 7.4{\%} experienced a worsening in visual function (5.1{\%} excluding the patients with progressive disease).CONCLUSION: Good local control rate and a low risk of RION indicate that mRS is a safe and effective treatment option in cases of large meningiomas.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Meningioma, Middle Aged, Optic Nerve Diseases, Pituitary Neoplasms, Postoperative Complications, Radiation Dosage, Radiation Injuries, Radiosurgery, Retrospective Studies, Sella Turcica, Treatment Outcome, Vision, Ocular, Young Adult, Journal Article",
author = "Marcello Marchetti and {Bianchi Marzoli}, Stefania and Valentina Pinzi and Irene Tramacere and Fumagalli, {Maria Luisa} and Milanesi, {Ida Maddalena} and Paolo Ferroli and Angelo Franzini and Marco Saini and Francesco DiMeco and Laura Fariselli",
year = "2016",
month = "5",
doi = "10.1227/NEU.0000000000001073",
language = "English",
volume = "78",
pages = "638--46",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Multisession Radiosurgery for Sellar and Parasellar Benign Meningiomas

T2 - Long-term Tumor Growth Control and Visual Outcome

AU - Marchetti, Marcello

AU - Bianchi Marzoli, Stefania

AU - Pinzi, Valentina

AU - Tramacere, Irene

AU - Fumagalli, Maria Luisa

AU - Milanesi, Ida Maddalena

AU - Ferroli, Paolo

AU - Franzini, Angelo

AU - Saini, Marco

AU - DiMeco, Francesco

AU - Fariselli, Laura

PY - 2016/5

Y1 - 2016/5

N2 - BACKGROUND: Concern about radiation-induced optic neuropathy (RION) has governed recent thinking about the role of radiation therapy in the treatment of meningiomas involving the anterior optic pathways. Despite this concern, during the last few years, the use of radiosurgery for such lesions has increased steadily.OBJECTIVE: To define both the tumor control rate and the risk of RION over a long-term follow-up period in a large cohort of patients treated with multisession radiosurgery.METHODS: The local control and visual outcome of 143 patients who underwent multisession radiosurgery (mRS) were evaluated. Neurological outcome was also analyzed. The data for the present study were obtained from a prospectively maintained database.RESULTS: The mean follow-up was 44 months (range, 12-113 months). All patients underwent mRS. The median prescription dose was 25 Gy delivered in 3 to 5 fractions. The prescription isodose, which typically encompassed at least 95% of the tumor, ranged from 65% to 86% (median, 80%). The mean tumor volume was 11.0 cm (range, 0.1-126.3 cm; median, 8 cm). The progression-free survival at 3, 5, and 8 years was 100%, 93%, and 90%, respectively. Compared with baseline, visual function improved in 36% of patients, whereas 7.4% experienced a worsening in visual function (5.1% excluding the patients with progressive disease).CONCLUSION: Good local control rate and a low risk of RION indicate that mRS is a safe and effective treatment option in cases of large meningiomas.

AB - BACKGROUND: Concern about radiation-induced optic neuropathy (RION) has governed recent thinking about the role of radiation therapy in the treatment of meningiomas involving the anterior optic pathways. Despite this concern, during the last few years, the use of radiosurgery for such lesions has increased steadily.OBJECTIVE: To define both the tumor control rate and the risk of RION over a long-term follow-up period in a large cohort of patients treated with multisession radiosurgery.METHODS: The local control and visual outcome of 143 patients who underwent multisession radiosurgery (mRS) were evaluated. Neurological outcome was also analyzed. The data for the present study were obtained from a prospectively maintained database.RESULTS: The mean follow-up was 44 months (range, 12-113 months). All patients underwent mRS. The median prescription dose was 25 Gy delivered in 3 to 5 fractions. The prescription isodose, which typically encompassed at least 95% of the tumor, ranged from 65% to 86% (median, 80%). The mean tumor volume was 11.0 cm (range, 0.1-126.3 cm; median, 8 cm). The progression-free survival at 3, 5, and 8 years was 100%, 93%, and 90%, respectively. Compared with baseline, visual function improved in 36% of patients, whereas 7.4% experienced a worsening in visual function (5.1% excluding the patients with progressive disease).CONCLUSION: Good local control rate and a low risk of RION indicate that mRS is a safe and effective treatment option in cases of large meningiomas.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Disease-Free Survival

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Meningioma

KW - Middle Aged

KW - Optic Nerve Diseases

KW - Pituitary Neoplasms

KW - Postoperative Complications

KW - Radiation Dosage

KW - Radiation Injuries

KW - Radiosurgery

KW - Retrospective Studies

KW - Sella Turcica

KW - Treatment Outcome

KW - Vision, Ocular

KW - Young Adult

KW - Journal Article

U2 - 10.1227/NEU.0000000000001073

DO - 10.1227/NEU.0000000000001073

M3 - Article

C2 - 26492428

VL - 78

SP - 638

EP - 646

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 5

ER -