title: Radiation therapy for hemangioendothelioma: the university of Florida experience.
abstract: OBJECTIVE
  The benefit of radiotherapy (RT) for unresectable hemangioendotheliomas or patients with a high risk of local recurrence is unclear. This single-institution report describes the long-term effectiveness of RT for hemangioendothelioma.
  
  
  METHODS
  From 1976 to 2009, 14 patients with nonmetastatic hemangioendothelioma were treated with RT at our institution. Median patient age was 45 years (range, 20 to 71 y). Nine patients had hemangioendothelioma of the extremities and 5 had spinal tumors. Eleven tumors originated from bone. Most tumors (n=12) were ≤5 cm in diameter. Nine patients had multifocal tumors. Four patients underwent surgery and postoperative RT, whereas 10 had RT alone. All 4 operative patients had microscopic negative margins. Median RT dose was 52.2 Gy (range, 45 to 60 Gy) for RT alone and 62.2 Gy (range, 60 to 64.8 Gy) for postoperative patients. Seven patients received 1.5-2 Gy once daily and 7 patients received 1.2 Gy twice daily. The median follow-up was 10.3 years (range, 0.1 to 28.0 y).
  
  
  RESULTS
  The 10-year local control, cause-specific survival, and overall survival rates were 100%, 86%, and 73%, respectively. Two patients experienced a distant metastasis and died within 3 months of starting definitive RT. Three patients died of intercurrent illness at a median of 10.5 years after treatment. Nine patients had no evidence of disease at most recent follow-up. No patients experienced greater than grade 1 acute or late toxicity from RT.
  
  
  CONCLUSIONS
  With no local recurrences and minimal risk of toxicity, our data suggest that RT can effectively manage this disease and radical surgery compromising function or cosmesis may be safely avoided with moderate-dose RT.
authors.affiliation: Departments of *Radiation Oncology ‡Orthopaedics §Pathology, University of Florida College of Medicine, Gainesville †University of Florida Proton Therapy Institute, Jacksonville, FL.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Scott
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Indelicato
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.forename: Charles P
authors.initials: CP
authors.lastname: Gibbs
authors.forename: Mark T
authors.initials: MT
authors.lastname: Scarborough
authors.forename: John D
authors.initials: JD
authors.lastname: Reith
authors.forename: Robert B
authors.initials: RB
authors.lastname: Marcus
authors.forename: Robert
authors.initials: R
authors.lastname: Zlotecki
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000532:radiotherapy; D005260:Female; D006390:Hemangioendothelioma / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult