| Results of Gamma Knife Radiosurgery for Hemangioblastoma |
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Su-Hee Cho, Do Hoon Kwon, Byung-Duk Kwun, Jeong-Hoon Kim, Chang-Jin Kim, Do-Hee Lee |
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Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
Objective
Hemangioblastoma is a benign lesion and the treatment of choice for this disease is surgical resection. However, Gamma knife radiosurgery (GKRS) can be a treatment option for the surgically inaccessible lesions, recurrence after operation, and multiple lesions. In this study, the authors analyzed radiological and clinical results after GKRS for hemangioblastoma.
Methods
Clinical data was analyzed retrospectively in 21 patients with 33 hemangioblastomas. There were twelve male and nine female patients aged from 15 to 74. Eight patients underwent open surgery before radiosurgery. Six patients with von Hippel-Lindau (VHL) disease had multiple lesions. Patients were classified into 3 groups which were solid tumor (group A, n=22), solid tumor with cystic portion (group B, n=4) and cyst with mural nodule (group C, n=7). The mean marginal dose of GKRS was 16.67Gy and mean follow-up duration was 34 months.
Results
Follow-up magnetic resonance imaging revealed decreased tumor size in 12 lesions, no change in 17, and increased size in 4. Overall tumor control rate was 87.9% and tumor control rate in VHL disease was 89%. Tumor control rates according to the tumor type were 90.9% in group A, 75% in group B, and 85.7% in group C which showed statistically beneficial result in group A compared to B and C (p=0.037). Three of twenty one patients were neurologically deteriorated by mass effect of the tumor, and seventeen patients were neurologically stationary or improved. One patient expired with renal failure. One in group A, four in group B, two in group C underwent retreatment for the residual or recurrent lesions.
Conclusion
GKRS is an effective treatment option for hemangioblastomas when surgical resection has some limitation. This study suggests that it is especially useful for solid lesions or the VHL disease with multiple lesions, but showed a limited effect when the tumor has cystic portion. |
| Key Words:
Hemangioblastoma, Gamma knife radiosurgery, von Hippel-Lindau disease. |
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