title: Phase II study to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas.
abstract: OBJECTIVE
  Cavernous sinus hemangioma is a rare vascular tumor. The direct microsurgical approach usually results in massive hemorrhage. Although radiosurgery plays an important role in managing cavernous sinus hemangiomas as a treatment alternative to microsurgery, the potential for increased toxicity with single-session treatment of large tumors is a concern. The purpose of this study was to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas.
  
  
  METHODS
  Fourteen patients with large (volume >20 cm(3)) cavernous sinus hemangiomas were enrolled in a prospective Phase II study between December 2007 and December 2010. The hypofractionated stereotactic radiotherapy dose was 21 Gy delivered in 3 fractions.
  
  
  RESULTS
  After a mean follow-up of 15 months (range, 6-36 months), the magnetic resonance images showed a mean of 77% tumor volume reduction (range, 44-99%). Among the 6 patients with cranial nerve impairments before hypofractionated stereotactic radiotherapy, 1 achieved symptomatic complete resolution and 5 had improvement. No radiotherapy-related complications were observed during follow-up.
  
  
  CONCLUSIONS
  Our current experience, though preliminary, substantiates the role of hypofractionated stereotactic radiotherapy for large cavernous sinus hemangiomas. Although a longer and more extensive follow-up is needed, hypofractionated stereotactic radiotherapy of 21 Gy delivered in 3 fractions is effective in reducing the tumor volume without causing any new deficits and can be considered as a treatment modality for large cavernous sinus hemangiomas.
authors.affiliation: Departments of Neurosurgery and CyberKnife, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.forename: Guanghai
authors.initials: G
authors.lastname: Mei
authors.forename: Jiazhong
authors.initials: J
authors.lastname: Dai
authors.forename: Li
authors.initials: L
authors.lastname: Pan
authors.forename: Enmin
authors.initials: E
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002426:Cavernous Sinus / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D035583:Rare Diseases / Q000473:pathology / Q000601:surgery*; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D047368:Tumor Burden