Gamma Knife Radiosurgery for Choroidal Hemangioma: A Single-Institute Series

Kyu Seon Chung, Won Seok Chang, Jong Hee Chang, Sung Chul Lee, Jin Woo Chang, Yong Gou Park, Hyun Ho Jung

Research output: Contribution to journalArticle

Abstract

Objective: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. Methods: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8–68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5–105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm3 (range: 124–1150 mm3), and the mean prescribed marginal dose was 11.6 Gy (range: 10–16 Gy) with 50% isodose lines. Results: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64%) and decreased in 1 (7%). Six patients (43%) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. Conclusions: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.

Original languageEnglish
JournalWorld Neurosurgery
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Radiosurgery
Hemangioma
Tumor Burden
Visual Acuity
Sturge-Weber Syndrome
Subretinal Fluid
Diathermy
Radiation Injuries
Induced Hyperthermia
Cryotherapy
Temazepam
Light Coagulation
Vitrectomy
Photochemotherapy
Retinal Detachment
Therapeutics
Blood Vessels
Radiotherapy
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Chung, K. S., Chang, W. S., Chang, J. H., Lee, S. C., Chang, J. W., Park, Y. G., & Jung, H. H. (Accepted/In press). Gamma Knife Radiosurgery for Choroidal Hemangioma: A Single-Institute Series. World Neurosurgery. https://doi.org/10.1016/j.wneu.2019.08.138
Chung, Kyu Seon ; Chang, Won Seok ; Chang, Jong Hee ; Lee, Sung Chul ; Chang, Jin Woo ; Park, Yong Gou ; Jung, Hyun Ho. / Gamma Knife Radiosurgery for Choroidal Hemangioma : A Single-Institute Series. In: World Neurosurgery. 2019.
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abstract = "Objective: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. Methods: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8–68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5–105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm3 (range: 124–1150 mm3), and the mean prescribed marginal dose was 11.6 Gy (range: 10–16 Gy) with 50{\%} isodose lines. Results: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64{\%}) and decreased in 1 (7{\%}). Six patients (43{\%}) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. Conclusions: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.",
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Gamma Knife Radiosurgery for Choroidal Hemangioma : A Single-Institute Series. / Chung, Kyu Seon; Chang, Won Seok; Chang, Jong Hee; Lee, Sung Chul; Chang, Jin Woo; Park, Yong Gou; Jung, Hyun Ho.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Gamma Knife Radiosurgery for Choroidal Hemangioma

T2 - A Single-Institute Series

AU - Chung, Kyu Seon

AU - Chang, Won Seok

AU - Chang, Jong Hee

AU - Lee, Sung Chul

AU - Chang, Jin Woo

AU - Park, Yong Gou

AU - Jung, Hyun Ho

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. Methods: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8–68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5–105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm3 (range: 124–1150 mm3), and the mean prescribed marginal dose was 11.6 Gy (range: 10–16 Gy) with 50% isodose lines. Results: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64%) and decreased in 1 (7%). Six patients (43%) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. Conclusions: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.

AB - Objective: Choroidal hemangioma (CH) is a benign vascular tumor that induces subretinal fluid collection or exudative retinal detachment and consequent visual symptoms. Current standard treatments for CH include cryotherapy, diathermy, photocoagulation, photodynamic therapy, transpupillary thermotherapy, and radiation therapy. Stereotactic radiosurgery has recently been applied to the treatment of CH because of its characteristic stiff dose-fall-off and accuracy. We have adopted gamma knife radiosurgery (GKRS) to treat CH and have retrospectively assessed tumor volume reductions and improvements to visual acuity achieved thereby. Methods: Fourteen patients with CHs were treated with GKRS from November 2006 to December 2017. Eight patients had circumscribed CH, and 6 exhibited diffuse CHs and were diagnosed with Sturge-Weber syndrome. The mean age of patients was 27.1 years (range: 8–68 years) and the mean duration of clinical or radiological follow-up was 40.2 months (range: 5–105 months). The mean volume of the tumors at the time of GKRS was 533.5 mm3 (range: 124–1150 mm3), and the mean prescribed marginal dose was 11.6 Gy (range: 10–16 Gy) with 50% isodose lines. Results: The tumor volume decreased by the last follow-up in all patients. The visual acuity improved in 9 patients (64%) and decreased in 1 (7%). Six patients (43%) required trans-pars plana vitrectomy before or after GKRS. There were no symptomatic complications from radiation injury during the follow-up periods. Conclusions: GKRS could be an acceptable alternative treatment for symptomatic CH when standard therapy is not feasible.

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