Fractioned radiotherapy safe and effective for optic nerve sheath meningiomas

Conformal fractionated radiotherapy should be the first choice of treatment for optic nerve sheath meningiomas, according to Silas Wang, MD.

"Optic nerve sheath meningiomas are rare and constitute only 1.3% of meningiomas," Dr. Wang said at the American Academy of Ophthalmology annual meeting.

Dr. Wang and colleagues from Yale University School of Medicine, New Haven, CT, used primary conformal fractioned radiotherapy (45.00 to 54.00 Gy in 25 to 29 fractions) in 16 patients, 14 of whom were women (average age, 45.1 years). Ninety-four percent of the patients had had vision loss. The mean follow-up was 45 months.

Dr. Wang reported that the visual acuity stabilized in 11 patients and the final visual acuity was 20/20 or better in nine patients. One patient had a progress decline in visual acuity to hand motion vision. There was an improvement of two or more lines of visual acuity in four patients. The visual fields improved by a mean of 3.2 decibels. In addition, the color vision stabilized. The delayed complications of the treatment included dry eye and hormonal changes. The results that Dr. Wang reported are consistent with those of a previous study.

"Conformal fractionated radiotherapy is effective in mild visual acuity loss," he concluded.