Radiosurgical Decompression for Benign Perioptic Tumors Causing Compressive Cranial Neuropathies: a Feasible Alternative to Microsurgery?

Overview

Journal J Neurooncol

Publisher Springer

Date 2016 Sep 8

PMID 27599827

Citations 2

Authors

Eun Jung Lee

Young Hyun Cho

KyoungJun Yoon

Byungchul Cho

Eun Suk Park

Chang Jin Kim

Sung Woo Roh

Affiliations

Soon will be listed here.

Abstract

Several studies have reported the efficacy and safety of hypofractionated stereotactic radiosurgery (hSRS) in the treatment of benign perioptic tumors. This study went further and evaluated the feasibility of hSRS in the treatment of those causing compressive cranial neuropathies (CCNs) among perioptic tumors with special consideration of functional improvement. Twenty-six patients with CCNs (CN II = 19; CN III/IV/VI = 9; CN V = 3) caused by perioptic tumors underwent hSRS between 2011 and 2015. hSRS was delivered in five fractions with a median marginal dose of 27.8 Gy (≈14 Gy in a single fraction, assuming an α/β of three) to a tumor volume of 8.2 ± 8.3 cm. All tumors except one shrank after treatment, with a mean volume decrease of 35 % (range 4-84 %) during the mean follow-up period of 20 months. In 19 patients (38 eyes) with compressive optic neuropathy, vision improved in 55.3 % of eyes (n = 21), was unchanged in 36.8 % (n = 14), and worsened in 7.9 % (n = 3) (2.6 % after excluding two eyes deteriorated due to transient tumor swelling). A higher conformity index (p = 0.034) and volume of the optic apparatus receiving >23.0 Gy (p = 0.019) were associated with greater tumor shrinkage. A greater decrease in tumor volume (p = 0.035) was associated with a better improvement in vision. Ophthalmoplegia and facial hypesthesia improved in six of nine (66.7 %) and three of three (100 %) patients, respectively. There was no newly developed neurological deficit. Decompressive SRS for benign perioptic tumors causing CCN is feasible using hypofractionation, representing a useful alternative to microsurgical resection.

Citing Articles

Does Endoscopic Transnasal Optic Nerve Decompression Followed by Radiosurgery Improve Outcomes in the Treatment of Parasellar Meningiomas?.

Matousek P, Cvek J, cabalova L, Misiorzova E, Krejci O, Lipina R Medicina (Kaunas). 2022; 58(8).

PMID: 36013604 PMC: 9414861. DOI: 10.3390/medicina58081137.

Clinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife® stereotactic radiosurgery.

Puataweepong P, Dhanachai M, Hansasuta A, Dangprasert S, Sitathanee C, Ruangkanchanasetr R J Neurooncol. 2018; 139(3):679-688.

PMID: 29846895 DOI: 10.1007/s11060-018-2913-6.

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