[Stereotactic radiotherapy of spinal hemangioblastoma]

Hemangioblastoma (HAB) is a benign, richly vascularized tumor that accounts for 2-6% of all spinal cord neoplasms and ranks third in the structure of intramedullary space-occupying lesions of the spinal cord. Hemangioblastoma may occur sporadically or, in approximately 30% of cases, as part of the clinical picture of a hereditary disease, von Hippel-Lindau disease. The aim of this study was to evaluate the efficacy and safety of stereotactic irradiation of hemangioblastomas of the spinal localization in patients with sporadic and von Hippel-Lindau-associated hemangioblastomas The results of stereotactic radiotherapy were evaluation of 210 spinal hemangioblastomas in 74 patients. Follow-up observation was available for 67 patients with 166 tumors. The observation period ranged from 6 to 193 months. Tumor growth control with an average follow-up period of 48 months (6-193) was 99%. The use of radiosurgery and hypofractionation for spinal hemangioblastoma, including associated with VHL syndrome, allows achieving high rates of relapse-free survival and tumor growth control with minimal toxicity, including with long-term follow-up. However, in the presence of a pronounced clinical picture, removal of GAB using a microsurgical approach remains the method of choice, since regression of existing symptoms rarely occurs after stereotactic radiotherapy. Increasing the total and single doses does not lead to improved results.