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TitelFunctional outcomes after radiotherapy in patients with progressive skull base meningioma
Abstract Nr.P03
DoelTo study visual and oculomotor outcome as well as putative complications after 3D conformal radiotherapy in patients with progressive skull base or optic nerve sheath meningioma.
MethodesWe reviewed 29 patients with a mean age of 56.7 years. Twenty-five patients had sellar and parasellar meningiomas: 11 with orbital extension; 4 patients had optic nerve sheath meningioma with intracranial involvement (3unilateral, 1bilateral). At diagnosis, 26 patients had visual loss, 13 patients had associated oculomotor palsy. Three patients had isolated oculomotor palsy, with V nerve neuralgia in 2. Before radiotherapy,19 patients had partial surgical resection, 10 others only radiotherapy. A total dose of 54 Gy in 30 fractions was delivered using a 3D conformal radiation technique.
ResultatenThe mean follow-up was 34 months (4-72): 6/26 patients had visual improvement (of 0.1-0.6), 5/29 pts improved oculomotor or trigeminal disturbances. In 18 patients, vision and oculomotor palsy were stabilized. Two patients had clinical and radiographic progression 3 to 4 years after radiation therapy. In 25/29 patients, annual MRI follow-up did not show any tumor modification. None of the patient developed optic nerve or brain radionecrosis. Twenty-four patients had an endocrinological follow-up: 5 had directly a pan-hypopituitarism, 6 a pituitary deficiency, at a mean time of 26 mo. after radiotherapy.
ConclusieOur series confirms the beneficial effect of radiotherapy combined or not with surgery in meningioma involving anterior visual pathway and oculomotor nerves: local tumor control in 93% and clinical improvement in 38% of the patients.
Auteur 1
NaamBOSCHI
InitialenA
InstituutDept of Ophthalmology
Auteur 2
NaamRenard
InitialenL
InstituutRadiation Oncology
Auteur 3
NaamRaftopoulos
InitialenCh
Instituut Neurosurgery
Auteur 4
NaamMaiter
InitialenD
InstituutEndocrinology
Auteur 5
NaamCosnard
InitialenG
InstituutNeuroradiology
Auteur 6
NaamDe Potter
InitialenP
InstituutOphthalmology Clin Univ St LUc
StadBruxelles
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