title: Stereotactic radiosurgery for hemangioblastomas of the brain.
abstract: OBJECTIVE
  To assess the effectiveness of stereotactic radiosurgery in achieving tumor control and improving survival in patients with hemangioblastoma, we evaluated results from patients who were managed at the University of Pittsburgh and the Mayo Clinic.
  
  
  METHODS
  Twenty-seven patients with 29 hemangioblastomas had stereotactic radiosurgery over a 10 year interval. The mean patient age was 32 years (range, 14-75 years). The tumor volumes varied from 0.36 to 27 ml (mean, 3.2 ml), and the mean tumor margin dose was 16 Gy (range, 11.7-20). Clinical and neuroimaging follow-up was obtained for all patients between 0.5 and 9 years (mean, 4 years) after radiosurgery.
  
  
  RESULTS
  At this assessment, 21 patients (79%) were alive and six (21%) had died. The median survival after radiosurgery was 6.5 years (actuarial 5 year survival = 75.1 +/- 11.5%). The median survival from the initial diagnosis was 15 years. Twenty two of 29 evaluable tumors were controlled locally. The two-year actuarial control rate was 84.5 +/- 7.1% and at five years, 75.2 +/- 8.9%. Multivariate testing of factors affecting good outcome indicated that smaller tumor volume and higher radiosurgical dose (> 18 Gy) were significant.
  
  
  CONCLUSIONS
  For small to moderate size hemangioblastomas, multiple or recurrent tumors, and for patients who are not surgical candidates, radiosurgery is a safe and effective option to control disease and improve survival.
authors.affiliation: Department of Neurological Surgery, and the Center for Image-Guided Neurosurgery 1, University of Pittsburgh, Pennsylvania, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jawahar
authors.forename: D
authors.initials: D
authors.lastname: Kondziolka
authors.forename: Y I
authors.initials: YI
authors.lastname: Garces
authors.forename: J C
authors.initials: JC
authors.lastname: Flickinger
authors.forename: B E
authors.initials: BE
authors.lastname: Pollock
authors.forename: L D
authors.initials: LD
authors.lastname: Lunsford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004307:Dose-Response Relationship, Radiation; D018325:Hemangioblastoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016634:Radiosurgery; D012086:Reoperation; D013238:Stereotaxic Techniques; D016019:Survival Analysis; D016896:Treatment Outcome