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The long-term outcomes of radiosurgery for intracranial hemangioblastomas.
[von hippel-lindau disease]
Optimal
timing
in
the
treatment
of
intracranial
hemangioblastoma
(
HB
)
remains
controversial
,
particularly
for
patients
of
von
Hippel-
Lindau
disease
(
VHL
)
with
multiple
small
lesions
.
We
evaluated
efficacy
of
stereotactic
radiosurgery
(
SRS
)
for
intracranial
HB
based
on
the
longer
follow-up
data
with
a
larger
number
of
patients
and
lesions
.
Twenty
-
one
patients
(
11
men
,
10
women
)
initially
underwent
SRS
for
57
intracranial
HBs
.
Seven
patients
had
sporadic
lesions
and
14
had
VHL
-related
lesions
.
During
the
follow-up
,
40
lesions
were
additionally
treated
in
VHL
patients
in
10
SRS
treatments
.
Thus
,
a
total
of
97
lesions
were
included
in
this
study
.
Median
tumor
volume
was
0
.
13
cm
(
3
)
(
range
,
0
.
004
-
9
.
5
cm
(
3
)
)
,
and
median
margin
dose
was
18
Gy
(
range
,
14
-
20
Gy
)
.
Median
duration
of
follow-up
was
96
months
(
range
,
3
-
235
mo
)
after
initial
SRS
treatment
.
Ten
tumors
in
7
patients
showed
progression
after
SRS
.
Actuarial
tumor
control
rates
after
SRS
at
5
and
10
years
were
94
%
and
80
%
,
respectively
.
Factors
associated
with
longer
control
were
solid
lesion
(
P
=
.
03
)
,
smaller
volume
(
P
=
.
01
)
,
and
lesions
associated
with
VHL
(
P
=
.
0005
)
in
univariate
analysis
.
Five
-
and
10
-
year
tumor
control
rates
were
67
%
and
44
%
for
sporadic
patients
and
97
%
and
83
%
for
VHL
patients
.
SRS
could
be
offered
as
an
effective
treatment
for
small
,
solid
,
and
VHL
-associated
HBs
.
If
the
tumors
show
apparent
enlargement
in
size
or
can
possibly
become
symptomatic
along
with
a
slight
increase
in
size
,
SRS
should
be
recommended
before
they
present
with
the
clinical
symptoms
.
Diseases
Validation
Diseases presenting
"multiple small lesions"
symptom
von hippel-lindau disease
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