Lesion reduction was sustained and visual function improved in eyes treated with fractionated stereotactic radiotherapy for cavernous venous malformation of the orbital apex.
All six patients in the prospective database review at Alfred Health Radiation Oncology center in Melbourne, Australia, continued to demonstrate response to treatment after at least 18 months of follow-up. Clinical measures of vision, proptosis and pain also improved.
Mean tumor volume at baseline was 3 cm3 as seen on T1 contrast-enhanced and T2-weighted MRI sequence.
Fractionated delivery of radiotherapy reduces risk for optic neuropathy through use of smaller doses over extended treatment duration, thus allowing normal tissue to repair between fractions and lowering risk for toxicity, the authors said.
Dosing protocol was 45 Gy in 1.8 Gy fractions, 50 Gy in 2 Gy fractions or 50.4 Gy in 1.8 Gy fractions, with maximum dose to the optic nerve ranging from 48.2 Gy to 52.5 Gy.
At 12 months after treatment, tumor reduction averaged 64%, and no complications attributable to treatment were reported over a median of 33 months of follow-up.
“Together with [other] studies, our series provides further evidence of [fractionated stereotactic radiotherapy] as a valid treatment option for this condition,” the author wrote. – by Patricia Nale, ELS
Disclosures: The authors report no relevant financial disclosures.