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Long-term efficacy of fractionated conformal radiotherapy for the management of primary optic nerve sheath meningioma
- Source :
- The British journal of ophthalmology. 103(10)
- Publication Year :
- 2018
-
Abstract
- Background/AimFractionated conformal radiotherapy (FCRT) is now used to treat vision-threatening optic nerve sheath meningioma (ONSM), but long-term efficacy and safety data are lacking; the purpose of this study was to assess these key data.MethodsThis is a retrospective chart review with prospective follow-up of adult patients treated with FCRT for primary ONSM at four academic medical centres between 1995 and 2007 with ≥10 years of follow-up after treatment.Results16 patients were identified with a mean post-treatment follow-up of 14.6 years (range: 10.5–20.7 years). The mean age at symptom onset was 47.6 years (range: 36–60 years). FCRT was performed at a mean of 2.3 years after symptom onset (range: 0.2–14.0 years). At last follow-up, visual acuity had improved or stabilised in 14 of the 16 (88%) patients, and 11 (69%) had retained or achieved ≥20/40. The mean deviation on automated perimetry remained stable (−14.5 dB pretreatment vs −12.2 dB at last follow-up; p=0.68, n=10). Two (11%) patients had persistent pain, proptosis or diplopia, compared with six (38%) pretreatment (p=0.11). Two (13%) patients developed radiation retinopathy more than 6 months after completion of therapy, one (50%) of whom had worse visual acuity compared with pretreatment. No patient developed tumour involvement or radiation damage in the fellow eye.ConclusionFCRT stabilises or improves visual function in patients with primary ONSM and is associated with a low risk of significant ocular sequelae. This treatment should be considered instead of surgery in patients with primary ONSM who require intervention due to loss of visual sensory and/or ocular motor function.
- Subjects :
- Adult
Male
medicine.medical_specialty
Visual acuity
Radiation retinopathy
Ocular motor
Visual Acuity
Conformal radiotherapy
Primary optic nerve sheath meningioma
010502 geochemistry & geophysics
01 natural sciences
03 medical and health sciences
Cellular and Molecular Neuroscience
0302 clinical medicine
medicine
Humans
Prospective Studies
0105 earth and related environmental sciences
Diplopia
business.industry
Optic Nerve Neoplasms
Middle Aged
medicine.disease
Sensory Systems
Surgery
Optic nerve sheath meningioma
Ophthalmology
Treatment Outcome
030220 oncology & carcinogenesis
Optic nerve
Visual Field Tests
Female
Dose Fractionation, Radiation
medicine.symptom
Radiotherapy, Conformal
Visual Fields
business
Meningioma
Follow-Up Studies
Subjects
Details
- ISSN :
- 14682079
- Volume :
- 103
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The British journal of ophthalmology
- Accession number :
- edsair.doi.dedup.....0320c3b1012974e31a3179849d205e82