Prognostic factors for functional outcome of patients with optic nerve sheath meningiomas treated with stereotactic radiotherapy
- Objective: To evaluate prognostic factors for a favorable outcome (improvement of the visual acuity or visual fields) after fractionated stereotactic radiotherapy (fSRT) of optic nerve sheath meningioma (ONSM). Methods: We performed a database search for ONSM treatments during the period from April 2008 to September 2019 in the prospective database for stereotactic radiosurgery/radiotherapy (SRS/SRT) of the Robert Janker Clinic Bonn (Department of Radiotherapy) and performed a literature review and meta-analysis of published data on ONSM between 2010 and 2019. Ophthalmic status before and after treatment was evaluated and the collective was dichotomized into two groups: functional improvement (FI; improvement of either visual acuity or visual fields) and non functional improvement (NFI; with stable or deteriorating visual acuity or visual fields). The two groups were compared regarding different variables: pretreatment visual acuity, age, gender, gross tumor volume (GTV), follow up (FU) time, tumor localization, and maximal retina dose. Results: Overall, 13 stereotactic radiotherapies were performed for ONSM (12 × fSRT, 1 × SRS). Mean follow up was 3 years (range: 1–5 years). The total dose was 50.4 Gy (5 × 1.8 Gy/week) in 12 patients treated with fSRT and 1 × 14 Gy in one SRS case. Mean GTV was 1.13 ccm (range: 0.44–2.20 ccm). During follow up, all tumors were stable or showed shrinkage of tumor volume (100% tumor control), no adverse events were observed, 53% of the patients achieved either better visual acuity or visual fields. Pretreatment visual acuity was significantly different between the FI and the NFI group (0.17 vs. 0.63, \(\it p\) = 0.03) in our series and in the meta analysis (\(\it p\) < 0.01). Moreover, shorter FU time and lower retinal dose were significantly linked (\(\it p\) < 0.05 and \(\it p\) < 0.01, respectively) with a better outcome in the meta-analysis but not in our patient cohort. Intracranial tumor localization, gender, and age were not significantly different between the two outcome groups. Conclusion: FSRT for ONSM achieves in over 50% of cases an improvement of the ophthalmic status with low morbidity and excellent tumor control in our series and the meta analysis. Patients with a favorable outcome had in all analysis a significantly higher visual acuity before treatment start. Therefore, we advocate using fSRT as early as possible before vision deterioration occurs.
Author: | Bogdan PinteaGND, Azize BoströmGND, Sotiris KatsigiannisGND, Konstantinos GousiasORCiDGND, Rares PinteaGND, Brigitta BaumertORCiDGND, Jan BoströmGND |
---|---|
URN: | urn:nbn:de:hbz:294-80152 |
DOI: | https://doi.org/10.3390/cancers13030522 |
Parent Title (English): | Cancers |
Subtitle (German): | evaluation of own and meta-analysis of published data |
Publisher: | MDPI |
Place of publication: | Basel |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2021/04/16 |
Date of first Publication: | 2021/01/29 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | fractionated stereotactic radiotherapy (fSRT); optic nerve sheath meningiomas (ONSM); visual acuity |
Volume: | 13 |
Issue: | 3, Article 522 |
First Page: | 522-1 |
Last Page: | 522-8 |
Institutes/Facilities: | Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Chirurgische Klinik und Poliklinik |
Knappschaftskrankenhaus Bochum, Klinik für Neurochirurgie | |
Gamma Knife Zentrum Bochum | |
open_access (DINI-Set): | open_access |
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |