Purpose:We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernoussinus meningiomas.Methods and Materials: From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas;84 female and 16 male patients were included. The mean patient age was 56 years. The most commonsymptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia(34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy wasadministered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed usinga Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator.Results: No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoingfollow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients requiredmicrosurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvementwas observed in patients suffering from exophthalmy, with 46% of these patients being restored to fullhealth. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity anda 50% improvement in type V neuropathy.Conclusions: FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery.In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functionaloutcomes.
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