title: Fractionated radiotherapy in the management of benign vascular tumors.
abstract: OBJECTIVE
  To better characterize the long-term therapeutic ratio of fractionated radiotherapy for benign vascular and lymphatic tumors.
  
  
  METHODS
  We retrospectively reviewed 19 medical records with 13 hemangiomas, 3 hemangioblastomas, and 3 benign lymphatic tumors treated with radiotherapy at the University of Florida from 1984 to 2007 to assess clinical presentation, treatment, and outcomes. The 10 men and 9 women had a median age of 43 years (range, 2 to 74 y). Six patients underwent radiotherapy alone; 13 patients underwent radiotherapy after surgery. Median radiotherapy dose was 40 Gy (range, 15 to 63.6 Gy). Median observed follow-up was 6.2 years (range, 1.6 to 25.0 y). Disease-free survival was defined by the absence of tumor progression or death from disease. Event-free survival was defined by the absence of tumor progression, death from disease, or severe complication.
  
  
  RESULTS
  The 5-year overall survival, disease-free survival, and event-free survival rates were 87%, 84%, and 74%, respectively. Immediately after treatment, there was 1 patient with tumor progression, 10 with stable disease, 7 with partial tumor regression, and 1 complete tumor regression. Ultimately, 3 patients experienced local tumor progression and 16 patients had long-term tumor control. Twelve patients had symptom improvement. Thirteen patients were alive with no evidence of progressive disease. Two patients were alive with symptomatic tumors. Four patients died: 2 from disease and 2 from unrelated causes. Two grade 3 and 2 grade 4 complications were noted.
  
  
  CONCLUSIONS
  When symptomatic benign vascular and lymphatic tumors are unresectable and not amenable to radiosurgery or embolization, fractionated radiotherapy represents a viable alternative with an acceptable long-term therapeutic ratio.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Leah H
authors.initials: LH
authors.lastname: Portnow
authors.forename: Michael
authors.initials: M
authors.lastname: Scott
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
authors.forename: Robert B
authors.initials: RB
authors.lastname: Marcus
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Indelicato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000601:surgery; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D018325:Hemangioblastoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D018191:Lymphangioma, Cystic / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D010015:Osteolysis, Essential / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult