Vol 26, No 6 (2021)
Research paper
Published online: 2021-10-04

open access

Page views 5833
Article views/downloads 320
Get Citation

Connect on Social Media

Connect on Social Media

The effect of fractionated gamma knife radiosurgery on visual acuity in patients with optic nerve tumor

Farid Kazemi Gazik1, Maziar Azar12, Foad Kazemi1, Tahereh Hadisinia3, Javad Teimouri2, Ghazale Geraily32
Rep Pract Oncol Radiother 2021;26(6):915-919.


Background: Stereotactic radiosurgery (SRS) method has been considered the first-line treatment option to treat patients involved with pre-optic nerve tumors. However, studies have shown that using fractionated SRS, normal tissue sparing and tumor dose can be strongly increased simultaneously. Our main goal was to illustrate the effects of fractionated SRS approach in optic nerve tumor treatment and its adjacent sensitive structures.

Materials and methods: 19 patients involved in optic nerve tumor with clinical symptoms of vision loss were treated with Gamma Knife radiosurgery in three sessions with 12 hours intervals between them. The prescribed dose was about 6.0 ± 1.2 Gy. Patient-related parameters including pre-treatment and after-treatment tumor size, visual acuity and visual field were evaluated using the Snell chart and MRI imaging. Patients were followed for about 14 months.

Result: The overall result showed vision improvement for patients with low and moderate visual loss. However, there was no significant improvement in patients with severe visual loss. Relative improvement was observed in blind patients, although poorly. There was no evidence of growth, recurrence, or new tumor after treatment in patients.

Conclusion: Fractionated gamma knife radiosurgery offers a safe and effective alternative for benign lesions adjacent to the optic nerve.


Article available in PDF format

View PDF Download PDF file


  1. Jee TK, Seol HoJ, Im YS, et al. Fractionated gamma knife radiosurgery for benign perioptic tumors: outcomes of 38 patients in a single institute. Brain Tumor Res Treat. 2014; 2(2): 56–61.
  2. Eldebawy E, Mousa A, Reda W, et al. Stereotactic radiosurgery and radiotherapy in benign intracranial meningioma. J Egypt Natl Canc Inst. 2011; 23(3): 89–93.
  3. Mukherjee KK, Kumar N, Tripathi M, et al. Dose fractionated gamma knife radiosurgery for large arteriovenous malformations on daily or alternate day schedule outside the linear quadratic model: Proof of concept and early results. A substitute to volume fractionation. Neurol India. 2017; 65(4): 826–835.
  4. McTyre E, Helis CA, Farris M, et al. Emerging Indications for Fractionated Gamma Knife Radiosurgery. Neurosurgery. 2017; 80(2): 210–216.
  5. Young RF. The role of the gamma knife in the treatment of malignant primary and metastatic brain tumors. CA Cancer J Clin. 1998; 48(3): 177–188.
  6. Kim JW, Park HR, Lee JM, et al. Fractionated Stereotactic Gamma Knife Radiosurgery for Large Brain Metastases: A Retrospective, Single Center Study. PLoS One. 2016; 11(9): e0163304.
  7. Kurt G, Tonge M, Börcek AO, et al. Fractionated gamma knife radiosurgery for optic nerve tumors: a technical report. Turk Neurosurg. 2010; 20(2): 241–246.
  8. Bisht R, Kale S, Nathanasabapathi G. Preliminary experience of fractionated stereotactic radiosurgery with extend system of Gamma Knife. Int J Cancer Ther Oncol. 2016; 4(1): 4114.
  9. Liu L, Bassano DA, Prasad SC, et al. The linear-quadratic model and fractionated stereotactic radiotherapy. Int J Radiat Oncol Biol Phys. 2003; 57(3): 827–832.
  10. Azar M, Kazemi F, Jahanbakhshi A, et al. Gamma Knife Radiosurgery for Cavernous Sinus Meningiomas: Analysis of Outcome in 166 Patients. Stereotact Funct Neurosurg. 2017; 95(4): 259–267.
  11. Starke RM, Williams BJ, Hiles V, et al. Gamma knife surgery for skull base meningiomas. J Neurosurgery. 2012; 116(3): 588–597.