S942
Clinical - Non-malignant & functional radiotherapy
ESTRO 2026
Conclusion: SRS provides substantial visual and anatomical benefits in symptomatic cCH, even among previously treated patients. Half of the cohort achieved meaningful visual improvement, accompanied by high rates of SRF resolution. However, baseline RD was linked to less favorable outcomes, highlighting the importance of early intervention before irreversible retinal damage develops. Keywords: choroidal hemangioma, stereotactic radiosurgery Digital Poster 830 Clinical outcomes and dosimetry of root entry zone-targeted radiosurgery for trigeminal neuralgia Bhooshan Zade, Sayli Rakshe, Vrushab Rao, Tittu V Thomas, Raghavendra Holla CyberKnife Radiosurgery and Radiation Oncology, Ruby Hall Clinic, Pune, India Purpose/Objective: Stereotactic radiosurgery (SRS) has emerged as an effective alternative to anti-epileptic drugs (AED) and
hemangioma (cCH) and to identify clinical predictors of visual recovery. Material/Methods: Patients with symptomatic cCH treated with SRS between 2014 and 2025 were retrospectively analyzed. Best-corrected visual acuity (BCVA) was recorded before and after SRS and converted to logarithm of the minimum angle of resolution (logMAR) values. A lower score on the logMAR scale indicates better vision. Logistic regression was used to identify predictors of visual improvement. Results: The study cohort included 30 patients (60.0% male, median age 46 years). SRS was performed as a primary treatment in 10 patients (33.3%) and as salvage therapy after photodynamic therapy and/or transpupillary thermotherapy in 20 (66.7%). The median follow-up duration was 20.8 months (range, 3.1–96.6 months). Before treatment, most patients presented with advanced visual impairment (median BCVA: 1.9 logMAR; range, 0.1–3.0). After SRS, the median BCVA improved significantly to 1.3 logMAR (Figure 1, p = 0.01). Visual improvement ( ≥ 0.2 logMAR) was achieved in 15 patients (50.0%), while 13 (43.3%) remained stable and 2 (6.7%) experienced deterioration. Among patients with visual improvement, median BCVA increased from 1.9 to 0.7 logMAR.Subretinal fluid (SRF) was present in 26 patients (86.7%) at baseline and resolved completely in 12 (46.1%) and partially in 10 (38.4%), yielding an overall resolution rate of 84.5%. Of six patients with baseline retinal detachment (RD), three (50.0%) achieved complete anatomical reattachment, although only one demonstrated visual improvement. Tumor regression was observed in 14 patients (46.7%), with 2 (6.7%) achieving complete response and 12 (40.0%) showing partial shrinkage. Fourteen patients (46.6%) had stable disease, and 2 (6.7%) were not assessable due to incomplete imaging.Univariate logistic regression analysis revealed that the presence of baseline RD was associated with a trend toward reduced likelihood of visual improvement (OR=0.121, 95% CI=0.013–1.120, p=0.06). Other variables, including age, sex, tumor volume, prior treatment, baseline SRF, and baseline BCVA, were not significantly correlated with post-SRS visual gain.Figure 1.Boxplot showing logMAR BCVA before and after SRS
microvascular decompression (MVD) to treat trigeminal neuralgia. Utilizing modern linear
accelerators, SRS allows for precise targeting with enhanced patient comfort through frameless immobilization. The root entry zone (REZ) of the nerve is a potential target for effective SRS, benefitting from the transition from central to peripheral myelin. This study aims to assess the clinical outcomes and dosimetry of REZ-targeted SRS in patients with TGN. Material/Methods: Patients with TGN treated between 2022 and 2025 with a diagnosed TGN refractory to AED and refusing MVD were studied. Baseline magnetic resonance imaging (MRI) scans were reviewed to identify any potentially visible site of conflict. All patients were planned for SRS to the REZ. Pre-treatment and serial post-treatment pain scores, and facial numbness were documented using the Barrow Neurological Institute (BNI) score for pain relief and facial numbness score for facial hypesthesia. Target volume, dose to the brainstem and ipsilateral Meckel’s cave were noted. Results: Twenty patients were analyzed with a median follow- up of 12 months [interquartile range (IQR) 7-20 months)]. Eighteen patients were treated on CyberKnife S7 and 2 patients on Truebeam STx. All patients were treated to a dose of 60Gy in a single fraction prescribed to the 85% isodose line. The median age of the population was 61.7 years (IQR 33- 76 years). Seven patients had left-sided TGN and the rest had right-sided TGN. Vascular conflict was noted
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