Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

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 -