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Stereotactic radiosurgery conferred long-term benefits in certain hemangioblastomas
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Stereotactic radiosurgery was associated with long-term beneficial effects in patients with small, solid and von Hippel–Lindau disease-associated hemangioblastomas, according to study results.
“If the tumors show apparent enlargement in size or can possibly become symptomatic along with a slight increase in size, stereotactic radiosurgery should be recommended before they present with the clinical symptoms,” the researchers wrote.
The timing of treatment for intracranial hemangioblastoma, specifically for those with von Hippel–Lindau (VHL) disease and multiple small lesions, remains controversial, according to background information in the study.
Researchers set out to assess the use of stereotactic radiosurgery (SRS) in 21 patients (11 men, 10 women) who previously underwent SRS for 57 intracranial hemangioblastomas. Seven patients had sporadic lesions and 14 had von Hippel–Lindau-related lesions.
During follow-up, patients with VHL underwent a combined 10 SRS treatments for 40 additional lesions.
The overall median volume of tumors was 0.13 cm³ (range, 0.004-9.5), and the median margin dose was 18 Gy (range, 14-20).
Median follow-up was 96 months (range, 3-235) after initial SRS treatment. During that time, a combined 10 tumors in seven patients progressed.
Researchers calculated actuarial tumor control rates after treatment of 94% at 5 years and 80% at 10 years.
Results of univariate analysis indicated that a solid lesion (P=.03), smaller tumor volume (P=.01) and having VHL disease-associated hemangioblastomas (P=.0005) were associated with longer periods of tumor control.
Among sporadic patients, tumor control rates were 67% at 5 years and 44% at 10 years. Among VHL patients, tumor control rates were 97% at 5 years and 83% at 10 years.
Disclosure: See the study for a list of the researchers’ relevant disclosures.
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