Narayanaswamy Parvathi, Vp Alisha, Manocha Sapna V, Jadhav Ganesh, Chaini Rohit K, Tyagi Sudheer, Oommen Saji, Chauhan Sunil, Kumar Harish, Yadav Ankit
Radiation Oncology, Indraprastha Apollo Hospitals, New Delhi, New Delhi, IND.
Neurological Surgery, Indraprastha Apollo Hospitals, New Delhi, New Delhi, IND.
Cureus. 2025 May 30;17(5):e85112. doi: 10.7759/cureus.85112. eCollection 2025 May.
Radiotherapy offers a favorable long-term outcome for the treatment of optic pathway glioma, but at a cost of neurocognitive impairment and decreased quality of life. This has led to a chemotherapy-first approach, deferring radiotherapy till disease progression. We present a case report wherein a 20-year-old female patient with left optic nerve glioma was treated with definitive radiotherapy using a self-shielding gyroscopic radiosurgery (GRS) system. We report the first published use of GRS in the treatment of optic nerve glioma. The patient was treated with 15 Gy at the 56% isodose line in two fractions on alternate days with 17 isocenters and 271 non-coplanar beams, amounting to a total treatment time of 63 minutes. The evaluation of the treatment plan shows considerable sparing of the normal structures, which may translate into better long-term clinical outcomes. A clinical follow-up after a month of treatment showed good clinical control without any undue treatment-related toxicity. Further follow-up is slated as per standard protocol. This case report opens up the potential for considering GRS after careful scrutiny as a first-line approach in the treatment of optic nerve glioma.
放射治疗对视神经胶质瘤的治疗具有良好的长期效果，但代价是神经认知功能损害和生活质量下降。这导致了一种先进行化疗的方法，将放射治疗推迟到疾病进展时。我们报告一例病例，一名20岁患有左侧视神经胶质瘤的女性患者使用自屏蔽陀螺式放射外科手术（GRS）系统进行了根治性放射治疗。我们报告了GRS首次用于治疗视神经胶质瘤的情况。患者在56%等剂量线处以15 Gy分两次隔日给予治疗，共17个等中心和271条非共面射束，总治疗时间为63分钟。治疗计划评估显示正常结构得到了相当程度的保护，这可能转化为更好的长期临床结果。治疗一个月后的临床随访显示临床控制良好，无任何过度的治疗相关毒性。将按照标准方案进行进一步随访。本病例报告表明，经过仔细审查后，GRS有可能作为视神经胶质瘤治疗的一线方法。
