Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study
Adomas Bunevicius1, Rithika Kormath Anand1, Mohanad Suleiman1
1Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
Neurosurgery
|January 21, 2021
Summary
Stereotactic radiosurgery (SRS) offers effective tumor control for perioptic meningiomas with high survival rates. However, higher doses to the optic apparatus and tumor progression increase the risk of vision decline.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Ophthalmology
Background:
- Stereotactic radiosurgery (SRS) is a growing treatment modality for perioptic meningiomas.
- Perioptic meningiomas pose a management challenge due to their proximity to critical visual structures.
Purpose of the Study:
- To evaluate the safety and efficacy of SRS in treating perioptic meningiomas.
- To identify factors influencing tumor control and visual outcomes after SRS.
Main Methods:
- Retrospective analysis of 438 patients with perioptic meningiomas treated with SRS across 12 institutions.
- Assessment of treatment parameters including tumor volume, prescription dose, and dose to the optic apparatus.
- Evaluation of tumor progression and visual decline rates during long-term follow-up.
Main Results:
- SRS achieved high 5-year (96%) and 10-year (89%) progression-free survival rates.
- Higher prescription doses (≥12 Gy) and single-fraction SRS were associated with improved tumor control.
- Visual decline occurred in 10% of patients, with higher rates linked to optic apparatus doses ≥10 Gy and tumor progression.
Conclusions:
- SRS is a safe and effective treatment for perioptic meningiomas, providing durable tumor control.
- Optimizing SRS parameters, particularly the dose to the optic apparatus, is crucial for preserving vision.
- Further research may refine SRS protocols to maximize efficacy while minimizing visual complications.
