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Long-term results of Gamma Knife surgery for optic nerve sheath meningioma
Dong Liu1, Desheng Xu, Zhiyuan Zhang
1Department of Neurosurgery, Tianjin Medical University Second Hospital, Hexi District, Tianjin, People's Republic of China.
Object:
The goal of this study was to assess the long-term results of Gamma Knife surgery (GKS) in patients harboring an optic nerve sheath meningioma (ONSM).
Methods:
Thirty patients harboring an ONSM were treated with GKS between 1998 and 2003. Gamma Knife surgery was performed as the sole treatment option in 21 of these patients and resection had been performed previously in 9 patients. The mean volume of the tumor at the time of GKS was 3.6 cm(3) (range 1.4-9.7 cm(3)), and the mean prescription peripheral dose was 13.3 Gy (range 10-17 Gy). The mean number of isocenters used to treat these lesions was 8 (range 5-14 isocenters).
Results:
At a median follow-up of 56 months, visual acuity improved in 11 patients, remained stable in 13 patients (including 4 patients who were completely blind before GKS), and deteriorated in 6 patients. Follow-up images were available in all patients and showed tumor regression in 20 patients and stable tumor in 8 patients. Persistent imaging evidence of progression was only present in 2 patients. With the exception of reversible conjunctival edema in 4 cases, no other serious acute side effect was observed.
Conclusions:
Gamma Knife surgery provides long-term tumor control for ONSM. The results of this study add substantial evidence that GKS may definitely become a standard treatment approach in selected cases of ONSM.
Insights
Gamma Knife surgery (GKS) offers long-term tumor control for optic nerve sheath meningioma (ONSM). This study shows GKS is a safe and effective treatment option for selected ONSM patients, with good tumor regression and stable vision outcomes.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Ophthalmology
Background:
- Optic nerve sheath meningiomas (ONSM) are rare tumors affecting vision.
- Long-term outcomes of Gamma Knife surgery (GKS) for ONSM require further evaluation.
Purpose of the Study:
- To assess the long-term efficacy and safety of Gamma Knife surgery (GKS) for treating optic nerve sheath meningiomas (ONSM).
Main Methods:
- Retrospective analysis of 30 patients with ONSM treated with GKS between 1998-2003.
- Tumor volumes ranged from 1.4-9.7 cm³, with a mean peripheral dose of 13.3 Gy.
- Median follow-up was 56 months.
Main Results:
- Tumor control achieved in 28/30 patients; regression in 20, stable in 8.
- Visual acuity improved in 11, remained stable in 13, and deteriorated in 6 patients.
- Only reversible conjunctival edema observed as a side effect.
Conclusions:
- Gamma Knife surgery provides durable tumor control for ONSM.
- GKS is a safe and effective treatment option for selected ONSM cases.
- Results support GKS as a potential standard treatment for ONSM.
