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Gamma knife surgery for
hemangioblastomas
Tago M, Terahara A, Shin M, Maruyama K, Kurita H, Nakagawa K, Ohtomo K
Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
tago-rad@h.u-tokyo.ac.jp
Object. The authors reviewed their 14-year experience using stereotactic
radiosurgery for the treatment of hemangioblastomas and define the role and
the proper strategy for radiosurgery of this condition.
Methods. This is a
retrospective study of 38 hemangioblastomas in 13 patients.
Seven patients
had von Hippel-Lindau disease.
All patients have undergone at least one
follow-up visit.
The median and mean tumor volumes were 0.23 cm3 and 0.72
cm3 respectively (range 0.004::4.84 cm3).
Twenty-eight tumors received 20 Gy
to the margin, and the remainder received 18 Gy.
The median clinical
follow-up period was 36 months (range 3-159 months).
No patient died.
The
survival rate was 84.6% (11 of 13 patients).
The actuarial 5- and 10-year
survival rates were both 80.8%.
The median radiological follow-up period was
35 months (range 7-147 months).
Only one tumor increased in volume 24 months
after treatment in association with an intratumoral hemorrhage.
The tumor
control rate was 97.4% (37 of 38 tumors).
Actuarial 5- and 10-year control
rates were both 96.2%.
New lesions and/or those increasing in size outside
the irradiated area were discovered in five patients (38.5%).
Nine tumors
revealed peritumoral contrast enhancement which was seen more frequently in
larger tumors with a volume greater than 0.5 cm3 (p = 0.0034).
Conclusions.
Gamma knife surgery is a safe and effective method to control
hemangioblastomas for as many as 10 years.
Higher doses and smaller tumors
probably contribute to good outcomes.
Recurrence outside the original
irradiated area is common.
Peritumoral contrast enhancement may be seen in
larger tumors.
The authors recommend regular imaging follow up and early
repeated treatment in the face of new or growing tumors.
PMID: 15662804 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15662804
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