Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

PURPOSE We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. MATERIALS AND METHODS We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31-65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm3 (range, 6.8-83.2 cm3), and fractionated radiation was administered to a total dose of 50-54 Gy with a daily dose of 2 Gy. RESULTS The median follow-up period was 6.8 years (range, 2.2-8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9-95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. CONCLUSION Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.