Precision radiotherapy for optic nerve sheath meningioma

What is it about?

In this retrospective study, we accrued 5 consecutive patients with primary optic nerve sheath meningioma (ONSM) who underwent intensity-modulated radiotherapy (IMRT) or fractionated stereotactic radiotherapy (FSRT) between September 2013 and May 2015. We suggest that early intervention with IMRT as well as FSRT is an effective and standard treatment option for not only stabilizing but also early improving the vision of patients with ONSM. Therefore, a paradigm shift is necessary to move the treatment option from surgery to early intervention using sophisticated radiotherapy for ONSM in Japan.

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Why is it important?

All patients experienced reestablishment of vision at the median follow-up time of 36 months (range: 18 – 54 months). Four of them noted early improvement of visual deficits during the treatment course (range: 2 – 4 weeks) and the remaining patient　 improved 3 weeks after completion of IMRT. The median tumor reduction was 53% (range: 39% – 80%). One patient with diabetes mellitus developed retinal bleeding as a result of radiation retinopathy 16 months after IMRT, although the doses were acceptable. The remaining 4 patients have no late toxicity at the follow-up time of 31 to 54 months.