Radiotherapy as Primary Treatment of Olfactory Groove Meningiomas is Associated with Preserved Cranial Nerve Function and Excellent Quality of Life

Objective: Data on radiotherapy (RT), including fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS), for olfactory groove meningiomas (OGMs) is limited, in part because of the rarity of the disease in this location. We present the first report of efficacy, toxicity, CN function and quality of life (QOL) in patients treated with primary RT for OGMs. Methods: We retrospectively identified seven patients who were treated with primary FSRT or SRS. Patients were followed clinically, with magnetic resonance imaging (MRI), and were sent Sino-Nasal Outcome Tests (SNOT- 20s). Results: At a median follow-up time of 64 months (range, 21 to 125), rates of local control, overall survival, and cause specific survival were 100%, 86%, and 100%, respectively. At presentation, four patients had hypo/anosmia; two, symptomatic deficit of visual acuity or fields; two, facial pain; two, tinnitus. After RT, three patients regained olfaction; two had improvement in visual function; two, decreased facial pain; two, resolved tinnitus. Three patients had a decrease and four had no change in lesion size on radiographic imaging. Headaches resolved in the few patients who presented with them. SNOT-20scores correlated with an excellent QOL pre-RT and on follow-up. Conclusion: Patients with OGMs treated with primary RT maintained excellent rates of local control and cause-specific survival, had preserved or improved CN function (notably, olfactory nerve function improved in three patients), and maintained excellent QOL. Further prospective studies are necessary to determine the role of RT in the multimodal care of OGMs.