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ZAP-X Stereotactic Radiosurgery for Optic Nerve Sheath Meningioma: A Case Report

Summary

A 68-year-old woman with a benign brain tumor growing around her optic nerve received cutting-edge radiation treatment called ZAP-X stereotactic radiosurgery. The treatment precisely delivered radiation beams from multiple angles to shrink the tumor by 44% over six months. The patient experienced complete relief from eye pain and pressure, with reduced bulging of the eye, while maintaining excellent safety with no complications or damage to surrounding healthy structures.

Background

Primary optic nerve sheath meningiomas (ONSMs) are benign tumors accounting for approximately 2% of orbital tumors and are a common cause of optic neuropathy. Radiotherapy is the preferred treatment modality over surgery due to risks of vascular damage and vision loss. The ZAP-X is the newest cranial stereotactic radiosurgery platform with self-shielding design and superior dose delivery characteristics.

Objective

To present the first documented case of ZAP-X SRS treatment for primary optic nerve sheath meningioma and demonstrate its safety and efficacy in delivering precise radiation to sensitive cranial structures.

Results

The patient tolerated the procedure well with no complications. At six-month follow-up, tumor volume was reduced by 44% (from 0.27 to 0.15 cm³) with complete resolution of left eye pain and pressure and significantly reduced proptosis. Secondary dose check accuracy was 99.7% with 99% gamma passing rate, and no vasogenic edema was observed.

Conclusion

This case demonstrates successful use of ZAP-X SRS for treating ONSM with high precision and favorable outcomes in symptom alleviation and tumor volume reduction. Further research is needed to evaluate long-term efficacy and broader applicability of the ZAP-X platform for cranial tumors in sensitive anatomical areas.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 40747197, DOI: 10.7759/cureus.87094
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