TY - JOUR
T1 - Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors
AU - Astradsson, Arnar
AU - Wiencke, Anne Katrine
AU - Munck af Rosenschold, Per
AU - Engelholm, Svend-Aage
AU - Ohlhues, Lars
AU - Roed, Henrik
AU - Juhler, Marianne
PY - 2014/5
Y1 - 2014/5
N2 - To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior skull base meningiomas and 55 patients treated with FSRT for pituitary adenomas between January 1999 and December 2009 with at least 2 years follow-up were included. Patients were followed up prospectively with magnetic resonance imaging scans, visual acuity and visual field examinations. RION was found in four (10%) patients with anterior skull base meningiomas and seven patients (13%) with pituitary adenomas. The five-year actuarial freedom from 25% RION visual field loss was 94% following FSRT. Actuarial 2-, 5- and 10-year tumor control rates were 100, 88.4 and 64.5% for anterior skull base meningiomas and 100, 98.2 and 94.9% for pituitary adenomas, respectively. Patients with an impaired visual field function pre-FSRT were more likely to experience worsened function (p = 0.016). We found that RION, was a relatively uncommon event, in a large prospective cohort of patients that were systematically monitored following FSRT of benign anterior skull base tumors. Long term tumor control was favorable, especially for pituitary adenomas.
AB - To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior skull base meningiomas and 55 patients treated with FSRT for pituitary adenomas between January 1999 and December 2009 with at least 2 years follow-up were included. Patients were followed up prospectively with magnetic resonance imaging scans, visual acuity and visual field examinations. RION was found in four (10%) patients with anterior skull base meningiomas and seven patients (13%) with pituitary adenomas. The five-year actuarial freedom from 25% RION visual field loss was 94% following FSRT. Actuarial 2-, 5- and 10-year tumor control rates were 100, 88.4 and 64.5% for anterior skull base meningiomas and 100, 98.2 and 94.9% for pituitary adenomas, respectively. Patients with an impaired visual field function pre-FSRT were more likely to experience worsened function (p = 0.016). We found that RION, was a relatively uncommon event, in a large prospective cohort of patients that were systematically monitored following FSRT of benign anterior skull base tumors. Long term tumor control was favorable, especially for pituitary adenomas.
KW - Adult
KW - Age Factors
KW - Aged
KW - Female
KW - Humans
KW - Kaplan-Meier Estimate
KW - Longitudinal Studies
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Optic Nerve Diseases
KW - Postoperative Complications
KW - Radiosurgery
KW - Retrospective Studies
KW - Skull Base Neoplasms
KW - Visual Acuity
KW - Visual Fields
KW - Visual Pathways
U2 - 10.1007/s11060-014-1399-0
DO - 10.1007/s11060-014-1399-0
M3 - Journal article
C2 - 24532196
SN - 0167-594X
VL - 118
SP - 101
EP - 108
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -