title: [The significance of radiation therapy for symptomatic vertebral hemangiomas (SVH)].
abstract: OBJECTIVE
  To evaluate the efficacy of radiation therapy (RT) for symptomatic vertebral hemangioma (SVH).
  
  
  METHODS
  Based on the Registry for Rare Benign Disorders (RRBD) of the German Cooperative Group on Radiation Therapy for Benign Diseases (GCG-BD), the clinical information, treatment plans and outcome data from seven cooperating German RT institutions were analyzed retrospectively.
  
  
  RESULTS
  Over a period of 39 years (1969-2008), a total of 84 patients with 96 symptomatic lesions underwent RT. The predominant indication was pain in 97.6%, and, in addition, 28.6% of patients had neurological deficits. The median total dose was 34 Gy (4.5-45 Gy), and the median single dose 2.0 Gy (0.5-3.0 Gy). After a median follow-up of 68 months (6-422 months), complete symptom relief (CR) occurred in 61.9% of patients, 28.6% had partial relief, and 9.5% had no relief (NR). The overall response rate (CR + PR) was 90.5%. In 26.2% of patients, radiologic signs of remineralization were noted. After a median follow-up of 70 months (8-124 months), symptom progression occurred in eight patients (9.5%). Therefore, the long-term rate of local control was 80.9%. Multivariate statistical analysis revealed a significantly higher rate of symptom relief and local control for total doses > or = 34 Gy. Side effects > RTOG/EORTC grade 2 were not observed.
  
  
  CONCLUSIONS
  RT is a safe and effective for treatment of SVH. Total doses of at least 34 Gy are recommended to achieve optimal treatment response.
authors.affiliation: Strahlenklinik, Klinikum Offenbach, Offenbach, Germany. Reiniheyd@aol.com
authors.forename: Reinhard
authors.initials: R
authors.lastname: Heyd
authors.forename: M Heinrich
authors.initials: MH
authors.lastname: Seegenschmiedt
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
authors.forename: Cornelia
authors.initials: C
authors.lastname: Winkler
authors.forename: Hans T
authors.initials: HT
authors.lastname: Eich
authors.forename: Frank
authors.initials: F
authors.lastname: Bruns
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Normann
authors.initials: N
authors.lastname: Willich
authors.forename: Oliver
authors.initials: O
authors.lastname: Micke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011879:Radiotherapy Dosage; D012042:Registries; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Neurosurg Clin N Am. 2008 Jan;19(1):17-29
references.pmid: 18156044
references.citation: Neurochirurgie. 1989;35(5):299-303, 305-8
references.pmid: 2630927
references.citation: J Neurosurg. 1993 Jan;78(1):36-45
references.pmid: 8416240
references.citation: Strahlenther Onkol. 1996 Dec;172(12):681-4
references.pmid: 8992637
references.citation: Int J Radiat Oncol Biol Phys. 2010 May 1;77(1):217-25
references.pmid: 19699592
references.citation: Spine (Phila Pa 1976). 1981 Jul-Aug;6(4):336-40
references.pmid: 7280822
references.citation: Strahlenther Onkol. 2010 Jan;186(1):18-23
references.pmid: 20082183
references.citation: Radiology. 2000 Feb;214(2):341-8
references.pmid: 10671579
references.citation: Skeletal Radiol. 1998 Mar;27(3):164-8
references.pmid: 9554009
references.citation: Neurosurgery. 1995 Aug;37(2):195-204; discussion 204-5
references.pmid: 7477769
references.citation: Neuroradiology. 2009 Jul;51(7):471-6
references.pmid: 19300988
references.citation: Strahlenther Onkol. 1999 Aug;175(8):405-8
references.pmid: 10481773
references.citation: Strahlenther Onkol. 2010 Jan;186(1):7-17
references.pmid: 20082182
references.citation: Rontgenpraxis. 2001;53(5):208-20
references.pmid: 11341017
references.citation: Int J Radiat Oncol Biol Phys. 2003 Jan 1;55(1):178-81
references.pmid: 12504051
references.citation: Pathol Int. 1996 Jan;46(1):71-8
references.pmid: 10846553
references.citation: Surg Neurol. 1998 Dec;50(6):535-47
references.pmid: 9870814
references.citation: Strahlenther Onkol. 2010 Jan;186(1):24-29
references.pmid: 20082184
references.citation: Hum Pathol. 1971 Sep;2(3):349-76
references.pmid: 4940691
references.citation: Strahlenther Onkol. 2009 Aug;185(8):506-11
references.pmid: 19652933
references.citation: J Radiol. 2005 Jan;86(1):41-7
references.pmid: 15785416
references.citation: Strahlenther Onkol. 2009 Dec;185(12):808-14
references.pmid: 20013090
references.citation: Strahlentherapie. 1977 Aug;153(8):522-5
references.pmid: 898220
references.citation: Neoplasma. 2002;49(5):338-41
references.pmid: 12458334
references.citation: Strahlenther Onkol. 2009 Feb;185(2):109-12
references.pmid: 19240997
references.citation: Strahlenther Onkol. 2010 Feb;186(2):82-90
references.pmid: 20127225
references.citation: Strahlenther Onkol. 2009 Aug;185(8):500-5
references.pmid: 19652932
references.citation: Neurosurg Focus. 2003 May 15;14(5):e16
references.pmid: 15669812