Abstract：
OBJECTIVE: Cranial Nerve Neuropathies (CNNs) often accompany Cavernous Sinus Meningioma (CSM), for which Stereotactic Radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSR) are established treatments. This study assesses CNNs recovery in CSM patients treated with LINAC, offering insight into treatment effectiveness.
METHODS: This study was conducted on 128 patients with CSM treated with LINAC-based SRS/FSR between 2005 and 2020 at a single institution. 46 patients presented with CNNs. The study analyzed patients\' demographics, clinical parameters, SRS/FSR treatment characteristics, post-treatment CNNs recovery duration, status, and radiological control on their last follow-up.
RESULTS: The median follow-up duration was 53.4 months. Patients were treated with SRS (n = 25) or FSR (n = 21). The mean pretreatment tumor volume was 9.5 cc decreasing to a mean end-of-follow-up tumor volume was 5.1 cc. Radiological tumor control was achieved in all cases. CNN recovery was observed in 80.4% of patients, with specific nerve recoveries documented as follows: extra-ocular nerves (43.2%), trigeminal nerve (32.4%), and optic nerve (10.8%). A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume (p < 0.001), and the median time-to-improvement was 3.7 months. Patients with tumor volumes exceeding 6.8 cc and those treated with FSR exhibited prolonged time-to-improvement (P < 0.03 and P < 0.04 respectively).
CONCLUSIONS: This study suggests that SRS/FSR for CSM provides good and sustainable CNNs recovery outcomes with excellent long-term radiological control. A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume. while shorter time-to-improvement was identified in patients treated with SRS compared to FSR, particularly in those with small pre-treatment tumor volume.
METHODS: This study was conducted on 128 patients with CSM treated with LINAC-based SRS/FSR between 2005 and 2020 at a single institution. 46 patients presented with CNNs. The study analyzed patients\' demographics, clinical parameters, SRS/FSR treatment characteristics, post-treatment CNNs recovery duration, status, and radiological control on their last follow-up.
RESULTS: The median follow-up duration was 53.4 months. Patients were treated with SRS (n = 25) or FSR (n = 21). The mean pretreatment tumor volume was 9.5 cc decreasing to a mean end-of-follow-up tumor volume was 5.1 cc. Radiological tumor control was achieved in all cases. CNN recovery was observed in 80.4% of patients, with specific nerve recoveries documented as follows: extra-ocular nerves (43.2%), trigeminal nerve (32.4%), and optic nerve (10.8%). A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume (p < 0.001), and the median time-to-improvement was 3.7 months. Patients with tumor volumes exceeding 6.8 cc and those treated with FSR exhibited prolonged time-to-improvement (P < 0.03 and P < 0.04 respectively).
CONCLUSIONS: This study suggests that SRS/FSR for CSM provides good and sustainable CNNs recovery outcomes with excellent long-term radiological control. A higher CNNs recovery rate was associated with a smaller pre-treatment tumor volume. while shorter time-to-improvement was identified in patients treated with SRS compared to FSR, particularly in those with small pre-treatment tumor volume.
摘要：
目的：颅神经神经病（CNNs）常伴随海绵状窦脑膜瘤（CSM），其中立体定向放射外科（SRS）或分割立体定向放射治疗（FSR）是确定的治疗方法。这项研究评估了接受LINAC治疗的CSM患者的CNN恢复情况，提供洞察治疗的有效性。
方法：这项研究是在2005年至2020年间在单一机构接受基于LINAC的SRS/FSR治疗的128例CSM患者中进行的。46名患者出现CNN。这项研究分析了患者的人口统计学，临床参数,SRS/FSR处理特性,后处理CNN恢复持续时间，status,和他们最后一次随访的放射控制。
结果：中位随访时间为53.4个月。患者接受SRS（n=25）或FSR（n=21）治疗。平均治疗前肿瘤体积为9.5cc,减少至平均随访结束时肿瘤体积为5.1cc。在所有情况下都实现了放射学肿瘤控制。在80.4%的患者中观察到CNN恢复,具体的神经恢复记录如下：眼外神经（43.2%），三叉神经(32.4%),和视神经（10.8%）。较高的CNNs恢复率与较小的治疗前肿瘤体积相关（p<0.001），中位改善时间为3.7个月.肿瘤体积超过6.8cc的患者和接受FSR治疗的患者表现出延长的改善时间（分别为P<0.03和P<0.04）。
结论：这项研究表明，CSM的SRS/FSR可提供良好且可持续的CNN恢复结果，并具有出色的长期放射学控制。较高的CNNs恢复率与较小的治疗前肿瘤体积相关。与FSR相比，SRS治疗的患者的改善时间更短，特别是那些治疗前肿瘤体积较小的患者。
方法：这项研究是在2005年至2020年间在单一机构接受基于LINAC的SRS/FSR治疗的128例CSM患者中进行的。46名患者出现CNN。这项研究分析了患者的人口统计学，临床参数,SRS/FSR处理特性,后处理CNN恢复持续时间，status,和他们最后一次随访的放射控制。
结果：中位随访时间为53.4个月。患者接受SRS（n=25）或FSR（n=21）治疗。平均治疗前肿瘤体积为9.5cc,减少至平均随访结束时肿瘤体积为5.1cc。在所有情况下都实现了放射学肿瘤控制。在80.4%的患者中观察到CNN恢复,具体的神经恢复记录如下：眼外神经（43.2%），三叉神经(32.4%),和视神经（10.8%）。较高的CNNs恢复率与较小的治疗前肿瘤体积相关（p<0.001），中位改善时间为3.7个月.肿瘤体积超过6.8cc的患者和接受FSR治疗的患者表现出延长的改善时间（分别为P<0.03和P<0.04）。
结论：这项研究表明，CSM的SRS/FSR可提供良好且可持续的CNN恢复结果，并具有出色的长期放射学控制。较高的CNNs恢复率与较小的治疗前肿瘤体积相关。与FSR相比，SRS治疗的患者的改善时间更短，特别是那些治疗前肿瘤体积较小的患者。
