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The treatment efficacy of radiotherapy for optic nerve sheath meningioma

Eye volume 38, pages 89–94 (2024)Cite this article

Subjects

Abstract

Objectives

Optic nerve sheath meningioma (ONSM) is a rare benign tumour that accounts for approximately 2% of all orbital tumours. Radiotherapy has gradually become an important treatment for ONSM because of its good effect in preserving or improving vision. We aimed to explore the effect of radiotherapy on tumour control and vision preservation/improvement in patients with ONSM.

Methods

Forty-three patients with primary ONSM treated in our institution from 2015 to 2021 were enrolled. The irradiation dose was from 50.4 to 54 Gy with 28–30 fractions. We evaluated the tumour volume on MRI or CT, and visual acuity before and after the radiotherapy.

Results

Thirty-four patients (79%) experienced a vision decrease at diagnosis. The mean duration of follow-up was 54.1 months (ranges: 18–93, median: 56). Among 25 patients who had tumour evaluation using MRI, 16 patients (37.2%) showed stable tumours, 7 patients (16.3%) had tumour shrinkage, but 2 patients (4.7%) experienced tumour progression. Among the 39 patients performing vision acuity evaluation, 16 patients (37.2%) had vision improvement or recovery. 16 of the 23 patients without vision improvement demonstrated severe visual loss at diagnosis. Two patients had evidence of tumour progression during the follow-up. Additionally, 4 (10.2%) patients had dry eyes, 7 (17.9%) patients experienced watery eyes, and 3 (7.7%) patients had eye swelling. Patients with vision loss for more than 12 months had a lower possibility of vision recovery than those with vision loss for less than 12 months.

Conclusions

Radiotherapy such as IMRT, VMAT, and 3D-CRT plays an important role in the treatment of ONSM. The probability of vision recovery is lower in patients with severe vision loss at diagnosis or the duration of vision loss is more than 12 months.

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Fig. 1: Dose distribution of radiation therapy (IMRT) for optic nerve sheath meningioma.
Fig. 2: Factors associated with improved vision.
Fig. 3: Kaplan–Meier curve of the progression-free survival.

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Data availability

The datasets used and analysed during the current study are available from the corresponding author upon reasonable request.

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Author notes

  1. These authors contributed equally: Tianci Tang, Jie Wang.

Authors and Affiliations

  1. Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China

    Tianci Tang, Jie Wang, Zhoushijia Zhai & Xinmao Song

  2. Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China

    Tong Lin

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Contributions

TT and JW studied concept and designed; analysis and interpretation of data; and wrote initial draft. TL re-examined the clinical data of all patients. ZZ provided study materials. XS studied concept and edited the draft and study supervision. All authors reviewed the manuscript.

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Correspondence to Xinmao Song.

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Tang, T., Wang, J., Lin, T. et al. The treatment efficacy of radiotherapy for optic nerve sheath meningioma. Eye 38, 89–94 (2024). https://doi.org/10.1038/s41433-023-02640-7

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