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Published on: July 16, 2018
Staged image guided robotic radiosurgery for optic nerve sheath meningiomas
Pantaleo Romanelli1, Livia Bianchi, Alexander Muacevic
1CyberKnife Center, Centro Diagnostico Italiano, Milan, Italy. radiosurgery2000@yahoo.com
Summary
Staged CyberKnife radiosurgery effectively treated optic nerve sheath meningiomas (ONSMs), preserving vision in most patients. This non-invasive approach offers a promising alternative for managing these challenging tumors.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Ophthalmology
Background:
- Optic nerve sheath meningiomas (ONSMs) are challenging optic pathway lesions.
- Microsurgery is often not indicated, and single-stage radiosurgery poses risks to vision.
- Staged radiosurgery may allow normal tissue repair while controlling tumor growth.
Purpose of the Study:
- To evaluate the efficacy and safety of staged robotic radiosurgery for ONSMs.
- To achieve local tumor growth control while preserving visual function.
Main Methods:
- Five patients with ONSMs received staged CyberKnife radiosurgery (20 Gy in 4 stages).
- Treatment planning utilized contrast-enhanced CT and volumetric MRI.
- Visual acuity, visual fields, and MRI were monitored post-treatment.
Main Results:
- Staged radiosurgery was well-tolerated and completed within 5 days.
- Local growth control was achieved in all patients.
- Four patients experienced vision restoration, and one showed modest improvement.
Conclusions:
- Staged CyberKnife radiosurgery is a fast, well-tolerated, non-invasive treatment for ONSMs.
- It demonstrates excellent visual outcomes.
- Further studies may establish it as a first-line treatment for ONSMs.
