I have a patient with an AVM which is in contact with the optic tract. Is there a known limitation (the maximal tolerated dose) for a single fraction or 4 fraction SRS.??
Thank you for your question. Most people would use a max point tolerance of 8Gy for single fraction SRS for the optical apparatus (some going to <3Gy to 10%V). This historical practice is derived from this paper, but it is more on the conservative side: https://journals.sagepub.com/doi/pdf/10.1177/153303460300200203
Prior to my post and also after you suggestion I reviewed again the article you are referring to.
In this comprehensive review there is a distinction in anatomical terms between nerve and chiasm and tracts but, to my understanding, it is not reflected in the data analyses. Thus, no distinction in terms of recommendations...
It seems that the data comes predominantly from outcomes related to anterior (chiasm and nerves) visual pathways exposure.
Thank you for your question. Most people would use a max point tolerance of 8Gy for single fraction SRS for the optical apparatus (some going to <3Gy to 10%V). This historical practice is derived from this paper, but it is more on the conservative side: https://journals.sagepub.com/doi/pdf/10.1177/153303460300200203
If you’d like a more contemporary review, please see this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479557/
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Thank you for your time and response.
Prior to my post and also after you suggestion I reviewed again the article you are referring to.
In this comprehensive review there is a distinction in anatomical terms between nerve and chiasm and tracts but, to my understanding, it is not reflected in the data analyses. Thus, no distinction in terms of recommendations...
It seems that the data comes predominantly from outcomes related to anterior (chiasm and nerves) visual pathways exposure.