Single and Multi-fraction Stereotactic Radiosurgery Dose Tolerances of the Optic Pathways

Data were pooled from published reports; from this data, dosimetric and clinical predictors of radiation-induced optic nerve/chiasm injury (RION) after stereotactic radiosurgery in 1 to 5 fractions were analyzed. RION risks are low (<1%) in the modern era with optic apparatus maximum point doses <10 Gy in 1 fraction, 20 Gy in 3 fractions and 25 Gy in 5 fractions (in patients without prior radiotherapy). More standardized dosimetric and toxicity reporting is needed to facilitate future pooled analyses and better define RION NTCP.

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