该研究的目的是确定经手术或放射手术治疗小脑血管母细胞瘤患者的局部肿瘤进展率和危险因素，并描述肿瘤进展后采取的治疗措施。作者对在1996年至2019年期间接受手术或立体定向放射手术（SRS）治疗小脑血管母细胞瘤的患者进行了单中心回顾性研究。进行了单变量和多变量回归分析，以检查与局部肿瘤控制有关的因素。符合研究纳入标准的患者共109例。总体而言，这些患者共有577个血管母细胞瘤，其中229个位于小脑。手术组和SRS组分别由106个和123个小脑血管母细胞瘤组成。对于接受手术的患者，肿瘤的治疗情况分别为5.7%亚全切除和94.3%完全切除。对于接受SRS的患者，平均靶体积为0.71 cm3，平均边缘剂量为18.0 Gy。手术组和SRS组的五年无病灶进展率分别为99%和82%。手术组和SRS组分别包含32%和97%的von Hippel-Lindau肿瘤，78%和7%的囊性血管母细胞瘤，以及分别为12.8 cm3和0.56 cm3的平均肿瘤体积。多变量分析显示，SRS组局部肿瘤进展相关因素包括年龄较大（HR 1.06，95% CI 1.03-1.09，p < 0.001）和囊性组分（HR 9.0，95% CI 2.03-32.0，p = 0.001）。作为挽救治疗，较小的肿瘤复发时更常采用再次SRS，且< 1.0 cm3的肿瘤复发无需再次SRS之后进行额外的挽救手术。手术和SRS都可以实现对血管母细胞瘤的局部控制，年龄和囊性特征与SRS治疗小脑血管母细胞瘤后的局部进展有关。在局部肿瘤复发的情况下，挽救手术和再次SRS是实现局部肿瘤控制的有效治疗方式，尽管对于较大的复发病变而言，切除可能更可取。

The purpose of this study was to identify rates of and risk factors for local tumor progression in patients who had undergone surgery or radiosurgery for the management of cerebellar hemangioblastoma and to describe treatments pursued following tumor progression.The authors conducted a retrospective single-center review of patients who had undergone treatment of a cerebellar hemangioblastoma with either surgery or stereotactic radiosurgery (SRS) between 1996 and 2019. Univariate and multivariate regression analyses were performed to examine factors associated with local tumor control.One hundred nine patients met the study inclusion criteria. Overall, these patients had a total of 577 hemangioblastomas, 229 of which were located in the cerebellum. The surgical and SRS cohorts consisted of 106 and 123 cerebellar hemangioblastomas, respectively. For patients undergoing surgery, tumors were treated with subtotal resection and gross-total resection in 5.7% and 94.3% of cases, respectively. For patients receiving SRS, the mean target volume was 0.71 cm3 and the mean margin dose was 18.0 Gy. Five-year freedom from lesion progression for the surgical and SRS groups was 99% and 82%, respectively. The surgical and SRS cohorts contained 32% versus 97% von Hippel-Lindau tumors, 78% versus 7% cystic hemangioblastomas, and 12.8- versus 0.56-cm3 mean tumor volumes, respectively. On multivariate analysis, factors associated with local tumor progression in the SRS group included older patient age (HR 1.06, 95% CI 1.03-1.09, p < 0.001) and a cystic component (HR 9.0, 95% CI 2.03-32.0, p = 0.001). Repeat SRS as salvage therapy was used more often for smaller tumor recurrences, and no tumor recurrences of < 1.0 cm3 required additional salvage surgery following repeat SRS.Both surgery and SRS achieve high rates of local control of hemangioblastomas. Age and cystic features are associated with local progression after SRS treatment for cerebellar hemangioblastomas. In cases of local tumor recurrence, salvage surgery and repeat SRS are valid forms of treatment to achieve local tumor control, although resection may be preferable for larger recurrences.