The Role of Stereotactic Radiosurgery for Intracranial Hemangioblastomas

Kuntz, Charles; Shaffrey, Christopher I.; Ondra, Stephen L.; Durrani, Atiq; Mummaneni, Praveen V.; Levin, Linda; Pettigrew, David B.

doi:10.1227/01.neu.0000313120.81565.d7

Cited by 134 publications

(33 citation statements)

References 85 publications

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“…Some previous reports noted worse progression-free survival for sporadic hemangioblastomas than for VHL-associated hemangioblastomas [12, 15] However, our study and that of Matsunaga et al did not observe such a difference [11]. …”

Section: Discussioncontrasting

confidence: 94%

“…Data from the literature have revealed that larger tumor volume is significantly associated with poorer progression-free survival after GammaKnife (GK) [7, 12], while another study only observed a trend in this direction [15]. In contrast, neither our study nor a report from Matsunaga et al detected a correlation in the size of the tumor with growth control after SRS [11].…”

Section: Discussioncontrasting

confidence: 84%

“…This is in agreement with most studies, which conclude that hemangioblastomas with large cysts are not suitable for SRS. The presence of a cystic component is significantly associated with poor LC [11–12]. Three other reports found that only the enhancing part, not the cystic portion of the contoured target volume, is effectively controlled by SRS [7, 10, 13].…”

Section: Discussionmentioning

confidence: 99%

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

Puataweepong

Dhanachai

Hansasuta

et al. 2014

Journal of Radiation Research

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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.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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

Puataweepong

Dhanachai

Hansasuta

et al. 2014

Journal of Radiation Research

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“…Thus, one explanation for the differences between the results of the above studies and ours could be that in a young cohort, changes of the spinal posture due to athletic training are muscular rather than structural or degenerative changes, as seen in older cohorts. It is also important to recognize that in different paediatric groups, there are wide variations in the sagittal alignment of the spine that can confound comparison (Kuntz et al, 2008).…”

mentioning

confidence: 99%

Effects of Athletic Training on the Spinal Curvature in Child Athletes

Betsch

Furian

Quack

et al. 2015

Research in Sports Medicine

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The purpose of this study was to examine the spinal posture in young athletes depending on training intensity. The spinal curvature of 245 children, age 8 to 12 years, was evaluated using rasterstereography. According to their weekly training time group 1 (mean age: 9.54 ± 1.18) did 2-6, group 2 (mean age: 9.49 ± 0.87) did 6-15 and group 3 (mean age: 9.68 ± 0.87) did over 15 hours of training. Group 1 had a significantly higher weight (p = 0.028) (33.86 ± 7. kg) than those of the more active groups (30.67 ± 6.49 kg and 29.46 ± 4.33 kg). The mean kyphotic angle decreased significantly (p < 0.001) with the amount of training per week from 46.86 ± 8.2° in group 1 to 40.08 ± 8° in group 3. We also found a significant decrease (p = 0.047) in lateral deviation with training from group 1 with 5.3 ± 3 mm to group 2 with 4.1 ± 1.6 mm. The results of our study suggest that higher training time can be associated with lower weight and decreases in thoracic kyphosis and lateral deviation of the spine.

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“…These reports have presented excellent control rates within short-term follow-up, with some reports of control rates exceeding 90% at 2 and 5 years. 7,8,17,22,25,28 Recent long-term prospective evaluation of radiosurgery for the treatment of cerebellar and brainstem hemangioblastomas in VHL disease revealed favorable control rates at 2 and 5 years but declining efficacy in tumor control over time, reaching 61% and 51% at 10 and 15 years, respectively. 2 Furthermore, exacerbation of neurological deficits as a result of increased peritumoral edema after radiosurgery may limit the use of this modality in symptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

Wind

Bakhtian

Sweet

et al. 2011

JNS

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Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in patients who underwent resection of brainstem hemangioblastomas. Methods Consecutive patients with VHL disease who underwent resection of brainstem hemangioblastomas with a follow-up of 12 months or more were included in this study. Serial functional assessments, radiographic examinations, and operative records were analyzed. Results Forty-four patients (17 male and 27 female) underwent 51 operations for resection of 71 brainstem hemangioblastomas. The most common presenting symptoms were headache, swallowing difficulties, singultus, gait difficulties, and sensory abnormalities. The mean follow-up was 5.9 ± 5.0 years (range 1.0–20.8 years). Immediately after 34 operations (66.7%), the patients remained at their preoperative functional status; they improved after 8 operations (15.7%) and worsened after 9 operations (17.6%) as measured by the McCormick scale. Eight (88.9%) of the 9 patients who were worse immediately after resection returned to their preoperative status within 6 months. Two patients experienced functional decline during long-term follow-up (beginning at 2.5 and 5 years postoperatively) caused by extensive VHL disease–associated CNS disease. Conclusions Generally, resection of symptomatic brainstem hemangioblastomas is a safe and effective management strategy in patients with VHL disease. Most patients maintain their preoperative functional status, although long-term decline in functional status may occur due to VHL disease–associated progression.

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The Role of Stereotactic Radiosurgery for Intracranial Hemangioblastomas

Abstract: A new classification of spinal deformity is proposed that provides a structure for defining deformity of all patient ages and spinal abnormalities.

Cited by 134 publications

References 85 publications

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

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

Effects of Athletic Training on the Spinal Curvature in Child Athletes

Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

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