SRS/FSR for CSM: Better CNNs Recovery & Radiological Control

Cranial nerve neuropathies (CNNs) often accompany cavernous sinus meningiomas (CSMs), a type of brain cancer. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSR) are established treatments for CSM.

Tehila Kaisman-Elbaz and the team aimed to evaluate CNNs recovery in patients with CSM treated with LINAC and to provide insights into treatment effectiveness.

The study involved 128 patients with CSM treated with LINAC-based SRS/FSR between 2005 and 2020 at a single institution. Of these, 46 patients presented with CNNs. Researchers analyzed demographics, clinical parameters, SRS/FSR treatment details, CNNs recovery duration and status, and radiological control at the last follow-up.
The results revealed a median follow-up duration of 53.4 months. Patients were treated with SRS (n=25) or FSR (n=21). The mean pretreatment tumor volume was 9.5 cc, which decreased to a mean end-of-follow-up volume of 5.1 cc. Radiological tumor control was achieved in all cases. CNN recovery was observed in 80.4% of patients, with recoveries noted for extra-ocular nerves (43.2%), trigeminal nerve (32.4%), and optic nerve (10.8%).

The study concluded that SRS/FSR for CSM yields effective and lasting CNN recovery outcomes with excellent long-term radiological control. Higher CNN recovery rates were linked to smaller pretreatment tumor volumes, and SRS was associated with a shorter time-to-improvement compared to FSR, especially in patients with smaller pretreatment tumor volumes.

Funding was provided by the Hebrew University of Jerusalem.

Source: https://link.springer.com/article/10.1007/s11060-024-04783-3

Kaisman-Elbaz, T., Blumenfeld, P., Wygoda, M. et al. (2024). “Recovery of cranial nerve neuropathies after LINAC-based stereotactic radiosurgery for benign cavernous sinus meningioma.” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04783-3