The clinical outcome of intracranial hemangioblastomas treated with linac-based stereotactic radiosurgery and radiotherapy

Abstract

Recent publications have reported stereotactic radiosurgery as an effective and safe treatment for intracranial hemangioblastomas. However, because of the low incidence of these particular tumors, reports on large patient number studies have not yet been available. The objective of this study was to analyze the clinical results of 14 patients with 56 intracranial hemangioblastomas treated with linear accelerator (linac)-based stereotactic radiosurgery (SRS) and radiotherapy (SRT) in the same institute. The median age of patients was 41 years (range, 28–73 years). Nine of the patients (64%) had von Hippel-Lindau disease. A total of 39 lesions (70%) were treated with CyberKnife (CK), and 17 lesions (30%) were treated with X-Knife. The median pretreatment volume was 0.26 cm3 (range, 0.026–20.4 cm3). The median marginal dose was 20 Gy (range, 10–32 Gy) in 1 fraction (range, 1–10 fractions). The median follow-up time was 24 months (range, 11–89 months). At the last follow-up, 47 tumors (84%) were stable, 7 (13%) decreased and 2 (4%) increased. The 1-, 2- and 6-year local control rates were 98%, 88% and 73%, respectively. No radiation complications were observed in this study. There was a trend toward local failure only in cystic tumors, but this trend was not found to be statistically significant. SRS/SRT achieved a high local control rate in intracranial hemangioblastomas without radiation-induced complications.

Treatment Strategies for Cerebellar Hemangioblastomas: Simple or Further Studies?

“…The progression-free survival after SRS at 1 year, 3 years, and 5 years was 96.9%, 95.0%, and 89.9% (7). The 1-year, 2-year, and 6-year local control rates after treatment with linear acceleratorebased SRS and stereotactic radiotherapy such as CyberKnife (Accuray, Sunnyvale, California, USA) and X-Knife were 98% (1 year), 88% (2 years), and 73% (6 years) (9). SRS was more effective for patients with VHL disease than for patients with sporadic hemangioblastomas; 5-year and 10-year tumor control rates were 67% and 44% for patients with sporadic hemangioblastomas and 97% and 83% for patients with VHL disease (4).…”

Image-guided stereotactic radiosurgery for treatment of spinal hemangioblastoma

“…The utility of radiosurgery and image-guided systems has been further supported by case series, which continue to show favorable outcomes. 1,5,7,9,10,17,[20][21][22] Furthermore, a recent systematic review surveying 10 papers that discussed radiosurgical treatment for intramedullary spinal tumors revealed that the CyberKnife (Accuray) was used in 87% of cases and afforded favorable clinical and radiological outcomes. 8 We present a large prospective cohort of spinal hemangioblastomas treated with radiosurgery.…”

Trigeminal Ophthalmic Branch Schwannoma: Case Report and Literature Review

“…25 . 28 Surgical resection is also the best treatment for orbital schwannomas. Subciliary approach is the most preferred method for the masses inferior and medial to the optic nerve.…”