Phase II study to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas.

Abstract

PURPOSE:

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.

CONCLUSION:

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: Xin Wang, Xiaoxia Liu, Guanghai Mei, Jiazhong Dai, Li Pan, Enmin Wang
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 83 Issue 2 Pg. e223-30 (Jun 01 2012) ISSN: 1879-355X [Electronic] United States
• PMID: 22361080 (Publication Type: Clinical Trial, Phase II, Journal Article, Review)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cavernous Sinus (surgery)
• Dose Fractionation, Radiation
• Female
• Hemangioma, Cavernous, Central Nervous System (diagnostic imaging, pathology, surgery)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Prospective Studies
• Radiosurgery (adverse effects, methods)
• Rare Diseases (pathology, surgery)
• Tomography, Spiral Computed
• Treatment Outcome
• Tumor Burden