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Torres-Ríos JA, Rodríguez-Camacho A, Basilio-Tomé E, Meraz-Soto JM, Camacho-Ordonez A, Romero-Luna G, Gutierrez-Aceves GA, Olhovich IG, Celis-López MA, Hernández-Sánchez LC, Moreno-Jiménez S. Radiation therapy for optic nerve sheath meningiomas: Local control and treatment related visual changes. World Neurosurg X 2024; 23:100291. [PMID: 38523881 PMCID: PMC10958468 DOI: 10.1016/j.wnsx.2024.100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Objective Our primary objective is to evaluate the local control of optic nerve sheath meningiomas (ONSMs) treated with ionizing radiation and related visual changes after treatment. Our secondary objective is to describe the clinical characteristics and perform an analysis of the treatment impact on the functional status of this group of patients. Methods We present our series of 19 patients treated with ionizing radiation therapy at our radio-neurosurgery unit between 2016 and 2022. The setting, ophthalmological follow-up, morbidity, and survival are analyzed and discussed. Results Patients were followed up, and the impact of treatment on local disease control, visual alterations of the affected eye, and functional status of the patient were analyzed. The progression-free survival (PFS) median was 60 months (95% CI 50.3-69.6 months). The estimated PFS rates at 48 and 66 months were 100% and 66%, respectively. At diagnosis, nine (47.3%) eyes were in amaurosis and ten (52.6%) with vision. Of the ten patients without amaurosis at the time of diagnosis, three (30%) maintained unchanged visual acuity, and seven (70%) had decreased visual acuity; three of them developed amaurosis during the first year after treatment (p = 0.018). Conclusions Using ionizing radiation therapy is a successful treatment for the local control of ONSMs. This therapeutic modality can compromise the visual acuity of the affected eye and improve dyschromatopsia and campimetry defects. The life prognosis is good for these patients, with a zero mortality rate, but their vision prognosis is poor.
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Affiliation(s)
- Jorge Alejandro Torres-Ríos
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Alejandro Rodríguez-Camacho
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
- Radiotherapy Department of Oncology Hospital, XXI Century Mexican Institute of Social Security, Mexico City, Mexico
| | - Estefania Basilio-Tomé
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Juan Marcos Meraz-Soto
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Azyadeh Camacho-Ordonez
- Neuro-Ophthalmology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Gerardo Romero-Luna
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Guillermo Axayacatl Gutierrez-Aceves
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
- Neurosurgery Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Irene González Olhovich
- Neuro-Ophthalmology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | - Miguel Angel Celis-López
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
- Neurosurgery Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
| | | | - Sergio Moreno-Jiménez
- Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
- Neurosurgery Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, 14269, Mexico
- American British Cowdray Medical Center, Cancer Center, Mexico City, 01120, Mexico
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