Radiosurgery of painful vertebral hemangiomas – preliminary report
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2005, Vol 7, Issue 5
Abstract
Background. Given the increasing popularity of radiosurgery in the treatment of cerebral hemangiomas, we attempted to implement such treatment for vertebral hemangiomas. The potential gains from this treatment modality may include reduced overall treatment time and reduced radiation dose delivered to the spinal cord.Material and methods. The clinical material consisted of 14 vertebral hemangiomas treated by radiosurgery. The mean symptom duration was 48.2 months. In 4 cases, a dose of 10 Gy was delivered, and in the remaining 10, a dose of 8 Gy. The mean follow-up was 6.2 months. The patients were re-examined 3 and 6 months after the treatment to evaluate pain relief, tumor size reduction, and presence of adipose conversion.Results. During the first follow-up examination, complete pain relief was found in 2 cases. The mean pain relief was 17%. One complete regression and one adipose conversion were found. Nine months after the treatment, pain decrease of 50% was found in one case and 40% in another. The mean pain relief was 20%. In 2 cases there was complete regression, and in 1 case partial (40%) regression; 4 cases of adipose conversion were also found. The mean pain relief during the last follow-up examination was 28% (only in 2 cases was there complete relief). Complete tumor regression was found in 3 cases, and partial (50%) in 2 cases. In 6 cases there was adipose conversion. A large discrepancy was found between radiological and subjective symptoms. Conclusion. Our results would seem to justify the conclusion that radiosurgery should not yet be the method of choice for vertebral hemangiomas. Its possible introduction into clinical practice should be preceded by a randomized clinical trial confirming its effectiveness.
Authors and Affiliations
Leszek Miszczyk, Grzegorz Woźniak, Wojciech
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