Simpson Alasdair Innes, Henry Caoimhe, Valentine Ronan M, Ferguson Richard, Peters Adam L, O'Brien Owen, Al-Ani Sarah, Cauchi Paul, Schipani Stefano
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, United Kingdom.
School of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, United Kingdom.
BJR Open. 2025 May 10;7(1):tzaf011. doi: 10.1093/bjro/tzaf011. eCollection 2025 Jan.
To report the clinical application, dosimetric features, efficacy, and toxicity profile of HyperArc (HA) for benign orbital tumours not amenable to surgical resection.
A retrospective interventional cohort study. Gross target volume included the radiologically evident tumour and the optic nerve (excluded in case of haemangioma). Dosimetry was compared between HA and volumetric modulated arc therapy (VMAT) radiotherapy. Patients were treated with HA and followed-up clinically and radiologically for response and toxicity assessment.
Eight patients were included in our study, six patients with an optic nerve sheath meningioma, one cavernous haemangioma and one orbital schwannoma. All patients demonstrated tumour regression, mean tumour volume prior to treatment of was 4916 mm and reduced to 3239 mm ( = .03). Three of eight patients showed improvement of visual acuity, three retained excellent pre-treatment vision and two patients had a reduction of vision. HA and VMAT planning target volume coverage dosimetry was similar (D95%: 98.7% and 98.6%, > .05). The dosimetry of the contralateral lens (32.2 vs 69.8 Gy), lacrimal gland (1.7 vs 7.8 Gy), optic nerve (9.0 vs 26.6 Gy), nasal cavity (10.2 vs 20.6 Gy) and ipsilateral temporal lobe (4.9 vs 11.6 Gy) was significantly improved ( < .001) with HA.
This is the first reported clinical application of HA for benign orbital tumours. HA was an effective and well tolerated treatment modality. HA offered better dosimetry for some of the OARs compared to VMAT.
This is the first article reporting the use of the HA system for planning and delivery of radiotherapy for orbital tumours.
报告HyperArc（HA）在无法进行手术切除的眼眶良性肿瘤中的临床应用、剂量学特征、疗效及毒性情况。
一项回顾性干预队列研究。大体靶体积包括影像学上可见的肿瘤及视神经（血管瘤病例除外）。比较了HA与容积调强弧形放疗（VMAT）的剂量学情况。患者接受HA治疗，并进行临床及影像学随访以评估反应和毒性。
本研究纳入8例患者，其中6例为视神经鞘膜瘤，1例海绵状血管瘤，1例眼眶神经鞘瘤。所有患者均显示肿瘤退缩，治疗前平均肿瘤体积为4916立方毫米，缩小至3239立方毫米（P = 0.03）。8例患者中有3例视力改善，3例维持治疗前的良好视力，2例视力下降。HA和VMAT的计划靶体积覆盖剂量学相似（D95%：98.7%和98.6%，P＞0.05）。HA对侧晶状体（32.2 Gy对69.8 Gy）、泪腺（1.7 Gy对7.8 Gy）、视神经（9.0 Gy对26.6 Gy）、鼻腔（10.2 Gy对20.6 Gy）及同侧颞叶（4.9 Gy对11.6 Gy）的剂量学有显著改善（P＜0.001）。
这是HA用于眼眶良性肿瘤的首次临床应用报道。HA是一种有效且耐受性良好的治疗方式。与VMAT相比，HA为一些危及器官提供了更好的剂量学。
这是第一篇报道使用HA系统进行眼眶肿瘤放疗计划和实施的文章。
