Hypofractionated stereotactic radiation therapy for optic nerve sheath meningiomas: A single-center experience and preliminary results.

Hypo-FSRT yielded 100% tumor control and 76.7% regression, but lower vision preservation (30.2%) than CFRT, particularly with moderate/severe baseline loss. Acute impairment (≤ 2 months) predicts better preservation.

Low preservation with normal baseline vision necessitates individualized planning balancing tumor control, vision, and cosmesis. CFRT preferred for vision preservation; optimal fractionation needs prospective validation.