Multisession Radiosurgery for Optic Nerve Sheath Meningiomas

Traditional treatment options for optic nerve sheath meningiomas (ONSM) include observation, surgery and radiotherapy, but to date none of these has become the clear treatment of choice. The role of the radiotherapy remained uncertain because of the concern about radiation related optic neuropathy In the recent past two large series of patients treated with a fractionated stereotactic radiotherapy confirmed these positive experiences in tumour control and greatly reduced the concern about the treatment related toxicity. Under the light of successful meningiomas treatment, radiosurgery, had proposed as a treatment option. Single session, high conformality, frame based radiosurgery systems are seldom if ever proposed as ONSMs treatment due to the known dose tolerance of the optic nerve. The first experience in ONSMs treatment with multisession radiosurgery treatment was quite promising. The aim of the present study is to prospectively evaluate the efficacy and safety of multisession radiosurgery in ONSMs treatment. In order to evaluate multisession radiosurgery 50 patients will be enrolled in the present study. All patients will be treated by using multisession radiosurgery, with 5 fractions of 5 Gy each to a total dose of 25 Gy prescribed to the 75-85% isodose line. Patients were evaluated both for tumor growth control and visual function.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Age: ≥ 18 years old
* Patients with suspected optic nerve sheath meningioma (single lesion) Pain and/or neurologic deficit
* KPS ≥ 70
* Written consent

Exclusion Criteria:

* Pregnancy
* Bilateral meningioma or chiasma involved
* Allergy to contrast medium