Abstract
Optic nerve sheath meningiomas (ONSM) are benign tumors which typically cause painless loss of vision in the affected eye. Traditional treatment includes observation, which can lead to gradual loss of vision and exophthalmos; surgery, where vision loss after microsurgical resection is not unusual; and radiotherapy. To date, none of these methods has clearly proven to be the treatment of choice for ONSM.
In recent years, stereotactic fractionated radiation therapy has increasingly been used instead of conventional radiotherapy. Stereotactic radiosurgery (SRS) with a single fraction is rarely possible in the treatment of meningiomas, because the vision would deteriorate due to the exceeded dose tolerance of the optic nerve. Frameless SRS devices, such as the CyberKnife, can provide extremely tight conformality and sub-millimetric accuracy combined with the ability to perform hypo-fractionated radiosurgery to improve the optic nerve’s tolerance to radiation. Finally, higher doses per session allow a significant shortening of the treatment, which is desirable for most patients while maintaining the same treatment outcome. The aim of this chapter is to provide a summary of the potential of ONSM radiosurgery, with a focus on CyberKnife treatment.
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Senger, C. (2020). Optic Nerve Sheath Meningiomas. In: Conti, A., Romanelli, P., Pantelis, E., Soltys, S., Cho, Y., Lim, M. (eds) CyberKnife NeuroRadiosurgery . Springer, Cham. https://doi.org/10.1007/978-3-030-50668-1_22
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DOI: https://doi.org/10.1007/978-3-030-50668-1_22
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