Lucía Paisán1, María Rosa Magallón Sebastián1, María Isabel García Berrocal1, Jesús Romero Fernández1, Irma Zapata Paz2, Beatriz Gil Haro2, Raquel Benlloch Rodríguez3, Jorge Fernando Obeso Herrero2, Olga Engel2, Alfonso Valcárcel Díaz1, Sofía Santana Jiménez2, Patricia Sarrión Rubio de la Torre2
1Puerta de Hierro University Hospital , Radiation Oncology, Madrid, Spain; 2Puerta de Hierro University Hospital, Radiation Oncology, Madrid, Spain; 3Puerta de Hierro University Oncology, Radiation Oncology, Madrid, Spain
Optic nerve meningioma (ONM) is a rare tumor and the optimal management still remains controversial. A late diagnosis and inappropriate treatment lead to a progressive loss of vision. The purpose of this retrospective study is to assess the effectiveness of early treatment with fractionated stereotactic radiotherapy for the ONM.
Between January 2010 and April 2020, 300 patients with intracranial meningioma were treated at the department of Radiation Oncology of the Hospital Universitario Puerta de Hierro, Madrid. Among them, only 9 patients (3%) were diagnosed with ONM and were included in the present study. Fractionated stereotactic RT was administrated to a PTV including tumor plus 2-3 mm margin up to a total dose of 50.4 Gy in 28 fractions of 1.8 Gy with non-coplanar fixed fields and image-guided intensity-modulated radiotherapy planning (IG-IMRT)
In our series, 8 patients were female. Mean age at diagnosis was 39 years (range 31-50). Mean post-treatment follow-up was 61months (range 2-108). Tumor control rate, considered as absence of progression in RMN studies, was 100%. Six patients improved their visual acuity and none of the remaining three patients with total vision loss at diagnosis improved it. No patients in our study experienced acute or late toxicity.
These findings support the use of radiation therapy for ONM. It is a safe noninvasive modality that stabilize or improves visual function and is associated with a low risk of ocular sequelae.