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Graefe's Archive for Clinical and Experimental Ophthalmology

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Open Access 01-10-2019 | Meningioma | Neuroophthalmology

Efficacy of intensity-modulated radiation therapy for optic nerve sheath meningioma

Authors: Hiroyuki Sasano, Keigo Shikishima, Manabu Aoki, Tsutomu Sakai, Yuki Tsutsumi, Tadashi Nakano

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2019

Abstract

Purpose

The present study examined the efficacy and complications associated with intensity-modulated radiation therapy (IMRT) for optic nerve sheath meningioma (ONSM) in 15 cases and compared visual function before and after treatment.

Methods

Consecutively diagnosed patients with ONSM treated with IMRT were evaluated from 2012 to 2017. We categorized ONSM with three growth patterns (diffuse, fusiform, or globular). Visual acuity, visual fields, and optic disc findings were assessed before and after IMRT. Ocular and systemic complications were evaluated during and after treatment.

Results

The 15 patients selected for analysis ranged in age from 33 to 77 years. Post-treatment observation periods were 8 to 57 months. After IMRT, tumor enlargement was not detected in any eyes, and tumor reduction was seen in 2 eyes. At final post-treatment follow-up, eyes with fusiform and globular growth maintained better visual acuity compared with pre-treatment, whereas 2 of 5 eyes with diffuse growth showed reduced vision. Five eyes with no apparent optic disc abnormality maintained better visual acuity compared with pre-treatment, whereas 8 of 10 eyes with disc edema and atrophy remained stable or showed reduced vision. Improvements were seen in all 5 eyes with optic discs negative for pre-treatment abnormalities. Final post-treatment visual field abnormalities improved in 11 eyes. All adverse events identified during IMRT improved rapidly during the treatment period.

Conclusion

IMRT for the treatment of ONSM achieved improvement and preserved visual function. In particular, early treatment with IMRT before the appearance of optic disc abnormalities can be more effective for improving visual function.

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Title: Efficacy of intensity-modulated radiation therapy for optic nerve sheath meningioma
Authors: Hiroyuki Sasano
Keigo Shikishima
Manabu Aoki
Tsutomu Sakai
Yuki Tsutsumi
Tadashi Nakano
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Meningioma
Meningioma
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04424-w

At a glance: The STEP trials

Springer Medicine

Efficacy of intensity-modulated radiation therapy for optic nerve sheath meningioma

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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