Gamma Knife radiosurgery for intracranial hemangioblastoma

• Intracranial hemangioblastoma are benign vascular tumors and can be either sporadic or associated with von Hippel-Lindau disease.
• Recurrent hemangioblastomas or those in difficult to access locations pose significant challenges to treating physicians.
• Gamma Knife radiosurgery (GKRS) can be used as either upfront therapy or salvage therapy for recurrent or residual hemangioblastoma.
• GKRS has the advantage of treating multiple intracranial hemangioblastoma lesions in a minimally invasive manner.
• GKRS can be considered as a primary therapeutic option in high-risk patients with intracranial hemangioblastoma.

Gamma knife radiosurgery (GKRS) has become a treatment option for intracranial hemangioblastomas, especially in patients with poor clinical status and also high-risk surgical candidates. The objective of this study was to analyze clinical outcome and tumor control rates. Retrospective chart review revealed 12 patients with a total of 20 intracranial hemangioblastomas treated with GKRS from May 1998 until December 2014. Kaplan-Meier plots were used to calculate the actuarial local tumor control rates and rate of recurrence following GKRS. Univariate analysis, including log rank test and Wilcoxon test were used on the Kaplan-Meier plots to evaluate the predictors of tumor progression. Two-tailed p value of <0.05 was considered as significant. Median follow-up was 64 months (2-184). Median tumor volume pre-GKRS was 946 mm3 (79-15970), while median tumor volume post-GKRS was 356 mm3 (30-5404). Complications were seen in two patients. Tumor control rates were 100% at 1 year, 90% at 3 years, and 85% at 5 years, using the Kaplan-Meier method. There were no statistically significant univariate predictors of progression identified, although there was a trend towards successful tumor control in solid tumors (p = 0.07). GKRS is an effective and safe option for treating intracranial hemangioblastoma with favorable tumor control rates.