Between August 2004 and September 2010, nine patients with 20
hemangioblastomas underwent spinal radiosurgery. Five patients had von Hipple-
Lindau disease. Four patients had multiple
tumors. Ten
tumors were located in the thoracic spine, eight in the cervical spine, and two in the lumbar spine.
Tumor volume varied from 0.08 to 14.4 cc (median 0.72 cc). Maximum
tumor dimension varied from 2.5 to 24 mm (median 10.5 mm). Radiosurgery was performed with a dedicated 6 MV
linear accelerator equipped with a micro-multileaf collimator. Median peripheral
tumor dose and prescription isodose were 12 Gy and 90%, respectively. Image guidance was performed by optical tracking of infrared reflectors, fusion of oblique radiographs with dynamically reconstructed digital radiographs, and automatic
patient positioning. Follow-up varied from 14 to 86 months (median 51 months).
RESULTS: CONCLUSIONS: Results of this limited experience indicate
linear accelerator-based radiosurgery is safe and effective for spinal cord
hemangioblastomas. Longer follow-up is necessary to confirm the durability of
tumor control, but these initial results imply
linear accelerator-based radiosurgery may represent a therapeutic alternative to surgery for selected patients with spinal
hemangioblastomas.