Hypofractionated Stereotactic Radiotherapy (hFSRT) by Halcyon in a case of Pre-Pontine Meningioma - A Case Report

INTRODUCTION

Prepontine and parapontine tumors are the most frequently occuring ones among the extracerebral tumors around the brain stem. Prepontine meningiomas are rare but present within the subachnoidal space simulating compressing lesions. Hereby, we report a case of pre pontine meningioma treated by Stereotactic Radiotherapy.

METHODS

49 year old female from Rajkot visited to Sterling Cancer Hospital in the month of March 2020, Rajkot with chief complain of double vision of the right eye for one month with no other neuro logical deficit. She was evaluated at Department of Neurosurery, Sterling hospital. MRI brain showed homogenous well defined lesion at right prepontine area abutting the brainstem. She was diagnosed as prepontine Meningioma radiologically. Biopsy could not be done. We discussed in our institutional multidisciplinary team and being decided for Hypofracionated Radiosurgery (hFSRT). She was treated with hFSRT by VAMT technique of dose 36 Gy/6# @ 600 cGy/# to the target lesion from 16.4.20 to 30.4.20 by 6 MV Halcyon machine. She tolerated to Radiotherapy very well.

RESULTS

She could achieved near complete response at 8 month (in Dec 2020) post radiation with small residual lesion. Her double vision was completely gone and her quality of life (QoL) was improved drastically and there was no treatment related side effect of high dose of radiotherapy or no neurological deficit. Her last follow up was in the month of March 2024. MRI Brain showed there was completer response after hFSRT.

CONCLUSION

Even if, biopsy could not be done because of anticipation of loss of vision, the vision and QoL of the patient could be restored because of the Hypofractionated Stereotactic Radiotherapy (hFSRT) technique of high precision radiotherapy. The patient could able to achieve disease free survival of 48 month without any recurrences till date. The complete opthalmological evaluation was done with perimetry was done of both the eyes with normal report. We wish a healthy and prosperous life for the patient in future.

hFSRT, Prepontione meningioma, Halcyon, QoL

PATIENT PERSPECTIVE

The patient and the relatives have expressed their gratitude towards Dr “Sarthak Kumar Mohanty” and Team Sterling cancer hospital, Rajkot for their excellent care. The patient and the relatives are extremely happy and satisfied.

Authors: Dr. Sarthak Kumar Mohanty, Dr. Gaurang Vaghani, Dr. Hard Vasavada, Nagendran P, Anzil M.S, Komal S., Arun Shiva