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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Fractionated radiotherapy for optic nerve sheath meningiomas
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Fractionated radiotherapy for optic nerve sheath meningiomas

机译：分次放疗治疗视神经鞘膜脑膜瘤

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摘要

Optic nerve sheath meningiomas (ONSM) are rare tumors of the meninges that surround the optic nerve as it enters the orbit. If left untreated, these benign tumors lead to progressive compression of the optic nerve and vascular compromise resulting in visual loss. Surgical resection of ONSM is associated with a high morbidity due to injury to the vascular supply of the optic nerve, with up to 94% of patients reporting worsened vision post-operatively. Fractionated radiotherapy is a non-invasive alternative to surgery for the treatment of ONSM that has demonstrated improved outcomes. The reported long-term tumor control rates approach 100%, with greater than 80% vision preservation or improvement after treatment. Recently, improved technology for delivery of radiotherapy, including stereotactic and three-dimensional conformal radiotherapy has emerged. The literature suggests that the modality of radiotherapy does not affect the outcomes as long as conformal targeting with a total dose of 50 Gy to 54 Gy and a fractional dose of less than 2.0 Gy is used. Radiosurgery is not generally used for ONSM due to the high toxicity to the optic nerve when high-dose single fraction radiation is given. Therefore, conformal fractionated radiotherapy appears to be the most effective treatment for ONSM, and should be used as a primary therapy unless there is a specific indication for surgical intervention.
机译：视神经鞘膜脑膜瘤（ONSM）是在视神经进入眼眶时围绕视神经的脑膜罕见肿瘤。如果不加以治疗，这些良性肿瘤会导致视神经进行性压迫和血管受损，从而导致视力丧失。由于视神经血管供应受损，ONSM的外科手术切除与高发病率相关，多达94％的患者术后视力下降。分级放疗是手术治疗ONSM的一种非侵入性替代方法，已证明其疗效得到改善。报告的长期肿瘤控制率接近100％，治疗后视力保持或改善超过80％。最近，出现了用于放射治疗的改进技术，包括立体定向和三维保形放射治疗。文献提示，只要使用总剂量为50 Gy至54 Gy且部分剂量小于2.0 Gy的保形靶向，放射疗法的方式就不会影响结果。放射外科手术通常不用于ONSM，因为当给予大剂量单次放射时，它对视神经具有高毒性。因此，保形分次放疗似乎是ONSM的最有效治疗方法，除非有手术干预的具体指征，否则应作为主要治疗方法。

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