The long-term results of gamma knife radiosurgery for hemangioblastomas of the brain
En-Min Wang
En-Min Wang
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Li Pan
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Bing-Jiang Wang
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Nan Zhang
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Liang-Fu Zhou
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Ya-Fei Dong
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Jia-Zhong Dai
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Pei-Wu Cai
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Hong Chen
Departments of Neurosurgery and Radiology, Huashan Hospital and Shanghai Gamma Knife Hospital Fudan University, Shanghai Neurosurgical Center, Department of Neuropathology, Hua Shan Hospital, Fudan University Shanghai, China
Object.The authors assessed the long-term result of gamma knife surgery (GKS) for hemangioblastomas of the brain (HABs) and show histopathological findings after GKS.
Methods.Thirty-five patients, 28 men and seven women, with a mean age of 36 years underwent GKS. Eighteen patients presented with multiple tumors and 17 with a solitary tumor. Twenty-one patients had von Hippel—Lindau (VHL) disease. The mean tumor diameter was 13 mm (range 5–55 mm). The mean follow up after GKS was 66 months (range 24–114 months). The mean prescription dose was 17.2 Gy (range 12–24 Gy) at the tumor margin. For tumors close to or within the brainstem a prescription dose of 12 to 13 Gy was used.
At the most recent follow up, 29 patients were alive, six were dead, and satisfactory tumor control had been achieved in 29. A stable or improved neurological status was obtained in 21 patients. Eight patients underwent open surgery because of tumor-associated cyst enlargement or the development of new tumors after GKS. Seven patients developed new tumors and five of them required a second GKS. The 1-year tumor control rate was 94%; 2 years, 85%; 3 years, 82%; 4 years, 79%; and 5 years, 71%. Histopathology showed that no tumor cells were found and there was degeneration and necrosis in a tumor nodule 48 months after GKS with a prescription dose of 18 Gy.
结论.Gamma knife surgery was a useful choice for small- or medium-sized, solid HAB in the long term, especially when the tumor margin dose was 18 Gy. Although GKS can treat multiple tumors in a single session, for HABs associated with VHL disease, GKS faces the dual problems of tumor recurrence or development of a new tumor.
ChandlerHCJr,&FriedmanWA:Radiosurgical treatment of a hemangioblastoma: case report.开云体育app官方网站下载入口34:353–555,1994Chandler HC Jr, Friedman WA: Radiosurgical treatment of a hemangioblastoma: case report.Neurosurgery 34:353–555, 1994
Chandler
HC
Jr
,
Friedman
WA
:
Radiosurgical treatment of a hemangioblastoma: case report.开云体育app官方网站下载入口
34
:
353
–
555
,
1994
Chandler HC Jr, Friedman WA: Radiosurgical treatment of a hemangioblastoma: case report.
Neurosurgery 34:353–555, 1994
8177399
10.1227/00006123-199402000-00021)| false
ChangSD,,MeiselJA,&HancockSL,et al:Treatment of hemangioblastomas in von Hippel-Lindau disease with linear accelerator-based radiosurgery.开云体育app官方网站下载入口43:28–35,1998Chang SD, Meisel JA, Hancock SL, et al: Treatment of hemangioblastomas in von Hippel-Lindau disease with linear accelerator-based radiosurgery.Neurosurgery 43:28–35, 1998
Chang
SD
,
Meisel
JA
,
Hancock
SL
,
et al
:
Treatment of hemangioblastomas in von Hippel-Lindau disease with linear accelerator-based radiosurgery.开云体育app官方网站下载入口
43
:
28
–
35
,
1998
Chang SD, Meisel JA, Hancock SL, et al: Treatment of hemangioblastomas in von Hippel-Lindau disease with linear accelerator-based radiosurgery.
Neurosurgery 43:28–35, 1998
9657185
10.1097/00006123-199807000-00018)| false
ConwayJE,,ChouD,&ClatterbuckRE,et al:Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease.开云体育app官方网站下载入口48:55–63,2001Conway JE, Chou D, Clatterbuck RE, et al: Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease.Neurosurgery 48:55–63, 2001
Conway
JE
,
Chou
D
,
Clatterbuck
RE
,
et al
:
Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease.开云体育app官方网站下载入口
48
:
55
–
63
,
2001
Conway JE, Chou D, Clatterbuck RE, et al: Hemangioblastomas of the central nervous system in von Hippel-Lindau syndrome and sporadic disease.
Neurosurgery 48:55–63, 2001
11152361)| false
Filling-KatzMR,,ChoykePL,&OldfieldE,et al:Central nervous system involvement in von Hippel-Lindau disease.Neurology41:41–46,1991Filling-Katz MR, Choyke PL, Oldfield E, et al: Central nervous system involvement in von Hippel-Lindau disease.Neurology 41:41–46, 1991
Filling-Katz
MR
,
Choyke
PL
,
Oldfield
E
,
et al
:
Central nervous system involvement in von Hippel-Lindau disease.Neurology
41
:
41
–
46
,
1991
Filling-Katz MR, Choyke PL, Oldfield E, et al: Central nervous system involvement in von Hippel-Lindau disease.
Neurology 41:41–46, 1991
1985294
10.1212/WNL.41.1.41)| false
GlaskerS,,BenderBU,&ApelTW,et al:The impact of molecular genetic analysis of the VHL gene in patients with haemangioblas-tomas of the central nervous system.J Neurol Neurosurg Psychiatry67:758–762,1999Glasker S, Bender BU, Apel TW, et al: The impact of molecular genetic analysis of the VHL gene in patients with haemangioblas-tomas of the central nervous system.J Neurol Neurosurg Psychiatry 67:758–762, 1999
Glasker
S
,
Bender
BU
,
Apel
TW
,
et al
:
The impact of molecular genetic analysis of the VHL gene in patients with haemangioblas-tomas of the central nervous system.J Neurol Neurosurg Psychiatry
67
:
758
–
762
,
1999
Glasker S, Bender BU, Apel TW, et al: The impact of molecular genetic analysis of the VHL gene in patients with haemangioblas-tomas of the central nervous system.
J Neurol Neurosurg Psychiatry 67:758–762, 1999
10567493
10.1136/jnnp.67.6.758)| false
JawaharA,,KondziolkaD,&GarcesYI,et al:Stereotactic radiosurgery for hemangioblastomas of the brain.Acta Neurochir142:641–645,2000Jawahar A, Kondziolka D, Garces YI, et al: Stereotactic radiosurgery for hemangioblastomas of the brain.Acta Neurochir 142:641–645, 2000
Jawahar
A
,
Kondziolka
D
,
Garces
YI
,
et al
:
Stereotactic radiosurgery for hemangioblastomas of the brain.Acta Neurochir
142
:
641
–
645
,
2000
Jawahar A, Kondziolka D, Garces YI, et al: Stereotactic radiosurgery for hemangioblastomas of the brain.
Acta Neurochir 142:641–645, 2000
10949438
10.1007 / s007010070107)| false
LatifF,,ToryK,&GnarraJ,et al:Identification of the von Hippel-Lindau disease tumor suppressor gene.Science260:1317–1320,1993Latif F, Tory K, Gnarra J, et al: Identification of the von Hippel-Lindau disease tumor suppressor gene.Science 260:1317–1320, 1993
Latif
F
,
Tory
K
,
Gnarra
J
,
et al
:
Identification of the von Hippel-Lindau disease tumor suppressor gene.Science
260
:
1317
–
1320
,
1993
Latif F, Tory K, Gnarra J, et al: Identification of the von Hippel-Lindau disease tumor suppressor gene.
Science 260:1317–1320, 1993
8493574
10.1126/science.8493574)| false
MelmonKL,&RosenSW:Lindau's disease. Review of the literature and study of a large kindred.Am J Med36:595–617,1964Melmon KL, Rosen SW: Lindau's disease. Review of the literature and study of a large kindred.Am J Med 36:595–617, 1964
Melmon
KL
,
Rosen
SW
:
Lindau's disease. Review of the literature and study of a large kindred.Am J Med
36
:
595
–
617
,
1964
Melmon KL, Rosen SW: Lindau's disease. Review of the literature and study of a large kindred.
Am J Med 36:595–617, 1964
14142412)| false
NiemelaM,,LimYJ,&SodermanM,et al:Gamma knife radiosurgery in 11 hemangioblastomas.J Neurosurg85:591–596,1996Niemela M, Lim YJ, Soderman M, et al: Gamma knife radiosurgery in 11 hemangioblastomas.J Neurosurg 85:591–596, 1996
PageKA,,还有WaysonK,&SteinbergGK,et al:Stereotaxic radiosurgical ablation: an alternative treatment for recurrent and multifocal hemangioblastomas. A report of four cases.Surg Neurol40:424–428,1993Page KA, Wayson K, Steinberg GK, et al: Stereotaxic radiosurgical ablation: an alternative treatment for recurrent and multifocal hemangioblastomas. A report of four cases.Surg Neurol 40:424–428, 1993
Page
KA
,
还有Wayson
K
,
Steinberg
GK
,
et al
:
Stereotaxic radiosurgical ablation: an alternative treatment for recurrent and multifocal hemangioblastomas. A report of four cases.Surg Neurol
40
:
424
–
428
,
1993
Page KA, Wayson K, Steinberg GK, et al: Stereotaxic radiosurgical ablation: an alternative treatment for recurrent and multifocal hemangioblastomas. A report of four cases.
Surg Neurol 40:424–428, 1993
8211662
10.1016/0090-3019(93)90225-P)| false
Pan
L
,
Wang
EM
,
Wang
BJ
,
et al
:
Gamma knife radiosurgery for hemangioblastomas.Stereotact Funct Neurosurg
70
(Suppl 1)
:
179
–
186
,
1998
Pan L, Wang EM, Wang BJ, et al: Gamma knife radiosurgery for hemangioblastomas.
Stereotact Funct Neurosurg 70 (Suppl 1):179–186, 1998
9782249
10.1159/000056420)| false
SoraS,,UekiK,&SaitoN,et al:Incidence of von Hippel-Lindau disease in hemangioblastoma patients: the University of Tokyo Hospital experience from 1954–1998.Acta Neurochir (Wien)143:893–8966,2001Sora S, Ueki K, Saito N, et al: Incidence of von Hippel-Lindau disease in hemangioblastoma patients: the University of Tokyo Hospital experience from 1954–1998.Acta Neurochir (Wien) 143:893–8966, 2001
Sora
S
,
Ueki
K
,
Saito
N
,
et al
:
Incidence of von Hippel-Lindau disease in hemangioblastoma patients: the University of Tokyo Hospital experience from 1954–1998.Acta Neurochir (Wien)
143
:
893
–
8966
,
2001
Sora S, Ueki K, Saito N, et al: Incidence of von Hippel-Lindau disease in hemangioblastoma patients: the University of Tokyo Hospital experience from 1954–1998.
Acta Neurochir (Wien) 143:893–8966, 2001
10.1007 / s007010170019)| false
WaneboJE,,LonserRR,&GlennGM,et al:The natural history of hemangioblastomas of the central nervous system in patients with von Hippel—Lindau disease.J Neurosurg98:82–94,2003Wanebo JE, Lonser RR, Glenn GM, et al: The natural history of hemangioblastomas of the central nervous system in patients with von Hippel—Lindau disease.J Neurosurg 98:82–94, 2003
Wanebo
JE
,
Lonser
RR
,
Glenn
GM
,
et al
:
The natural history of hemangioblastomas of the central nervous system in patients with von Hippel—Lindau disease.J Neurosurg
98
:
82
–
94
,
2003
Wanebo JE, Lonser RR, Glenn GM, et al: The natural history of hemangioblastomas of the central nervous system in patients with von Hippel—Lindau disease.
J Neurosurg 98:82–94, 2003
12546356
10.3171/jns.2003.98.1.0082)| false
WeilRJ,,LonserRR,&DeVroomHL,et al:Surgical management of brainstem hemangioblastomas in patients with von Hippel—Lindau disease.J Neurosurg98:95–105,2003Weil RJ, Lonser RR, DeVroom HL, et al: Surgical management of brainstem hemangioblastomas in patients with von Hippel—Lindau disease.J Neurosurg 98:95–105, 2003
Weil
RJ
,
Lonser
RR
,
DeVroom
HL
,
et al
:
Surgical management of brainstem hemangioblastomas in patients with von Hippel—Lindau disease.J Neurosurg
98
:
95
–
105
,
2003
Weil RJ, Lonser RR, DeVroom HL, et al: Surgical management of brainstem hemangioblastomas in patients with von Hippel—Lindau disease.
J Neurosurg 98:95–105, 2003
12546357
10.3171/jns.2003.98.1.0095)| false
