S392
Clinical - CNS
ESTRO 2026
parameters and visual outcome. Results:
Hypofractionated Radiotherapy withSimultaneous Integrated Boost and Concurrent/Adjuvant Temozolomide. J Pers Med.2021 Nov 4. doi: 10.3390/jpm11111145. Roa W et al. Current developments in the radiotherapy approach to elderly andfrail patients with glioblastoma multiforme. Expert Rev Anticancer Ther. 2009Nov;9. doi: 10.1586/era.09.128.Nguyen LT et al. Outcomes in newly diagnosed elderlyglioblastoma patients after concomitant temozolomide administration andhypofractionated radiotherapy. Cancers (Basel). 2013 Sep 24. doi:10.3390/cancers5031177. Keywords: glioblastoma, hypofractionation Digital Poster Highlight 4708 Visual Outcome and Dose Tolerance of the Optic Apparatus in Fractionated Radiotherapy for Sphenoid Wing and Optic Sheath Meningiomas Diana-Coralia Dehelean 1 , Sebastian Hubertus Maier 1,2 , Alexander Nitschmann 1 , Michael Schmeling 1 , Daniel Felix Fleischmann 1,3 , Claus Belka 1,2 , Stephan Schönecker 1,2 , Sebastian Norbert Marschner 1,3 1 Department of Radiation Oncology, University Hospital LMU Munich, Munich, Germany. 2 Bavarian Cancer Research Center, BZKF, Munich, Germany. 3 German Cancer Consortium, DKTK, Munich, Germany Purpose/Objective: Meningiomas located at the skull base pose a challenge for treatment due to proximity to critical brain structures such as optic chiasm and nerves or the brain stem. Radiation-associated visual impairment is caused among others by ischemic vascular injury of the optic nerve, opacity of the lens or demyelination of glial cells [1], [2]. This work presents a monocentric retrospective analysis on the visual outcome and local control after radiation of patients with sphenoid wing meningioma and optical sheath meningioma at the Ludwig Maximillian University Hospital in Munich. The study was approved by the Ethics Comitee of the Ludwig Maximillian University Hospital. Material/Methods: All patients treated both definitive or postoperative for sphenoid wing or optic sheath meningiomas between 2012 and 2024 were included in the study. Eligibility criteria required IMRT or VMAT planning, no prior brain irradiation and available follow-up data. Visual acuity and diplopia were evaluated according to CTCAE v5.0. Pre- and post-radiation assessment were based on clinical documentation and ophthalmologic examinations. Radiation plans, including organs at risk and target contours, dose distributions were pseudonymized and uploaded to Elekta’s ProKnow software to analyse correlations between treatment
The cohort included 131 female (80%) and 33 male patients (20%) with an average age of 58 years at the time of treatment. Upon histopathological evaluation, 84 patients had meningioma WHO grade 1 (51%), 16 patients WHO grade 2 (10%) while 64 patients (39%) were diagnosed solely based on imaging. The average total dose of radiation was 54Gy (range 25-60) in an average of 30 fractions (5-33). The maximum dose tolerated to the optic nerve or chiasm was Dmax < 55Gy according to the ESTRO-ACROP guideline [3]. 11 patients (6,7%) had progression. 21 patients (12,8%) presented with visual impairment after treatment, 2 patients due to optical neuropathy (1,1%). At the time of submission dose analysis with ProKnow is still ongoing. Conclusion: Fractionated radiotherapy for sphenoid wing and optic sheath meningiomas provides high local control with low recurrence and minimal symptomatic toxicity. Doses below 55 Gy to the optic apparatus appear safe and effective. Further dose correlation analysis using ProKnow is ongoing to identify patients at higher risk for visual impairment. References: [1] B. Kinaci-Tas, T. Alderliesten, F. D. Verbraak, and C. R. N. Rasch, “Radiation-Induced Retinopathy and Optic Neuropathy after Radiation Therapy for Brain, Head, and Neck Tumors: A Systematic Review,” Cancers (Basel), vol. 15, no. 7, p. 1999, Mar. 2023, doi: 10.3390/cancers15071999.[2] A. R. Carey, B. R. Page, and N. Miller, “Radiation-induced optic neuropathy: a review,” British Journal of Ophthalmology, vol. 107, no. 6, pp. 743–749, Jun. 2023, doi: 10.1136/bjo-2022-322854.[3] S. E. Combs et al., “ESTRO ACROP guideline for target volume delineation of skull base tumors,” Radiotherapy and Oncology, vol.
156, pp. 80–94, Mar. 2021, doi: 10.1016/j.radonc.2020.11.014. Keywords: meningioma, visual impairment, hypofractionation
Digital Poster 4771
Patterns of recurrence and local control in WHO grade 2 meningiomas according to radiotherapy modality: a retrospective institutional analysis Julio C Montiel-Gálvez 1 , Alejandro Villalvazo-Anaya 1 , Diana L Adame-Carranza 1 , Enrique Gutiérrez-Valencia 2 , Luis E Ayala-Hernández 3 , Irving E Sánchez-Rodríguez 1 1 Radiation Oncology, National Institute of Social Security, Guadalajara, Mexico. 2 Radiation Oncology, Dr. H. Bliss Murphy Cancer Centre, Memorial University, St. John’s, NL, Canada. 3 Department of Exact Sciences and Technology, University Center of
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