Does post-operative radiotherapy improve the treatment outcomes of intracranial hemangiopericytoma? A retrospective study

Lanwei Xu,Wei Wang,Yee-Min Jen,Junpeng Li,Qiyuan Zhou,Yangshu Zhou,Li Liang,Fengjiao Zhang,Jianbiao Xiao,Yi Ding,Xuehui Wu,Fen Chen

doi:10.1186/s12885-021-08594-x

Abstract

BackgroundIntracranial hemangiopericytoma is a rare disease and surgery is the mainstay treatment. Although postoperative adjuvant radiotherapy is often used, there are no reports comparing different radiotherapy techniques. The purpose of this study is to analyze the impact of post-operative radiotherapy and different radiotherapy technique on the results in patients with intracranial hemangiopericytoma (HPC).MethodsWe retrospectively reviewed 66 intracranial HPC patients treated between 1999 and 2019 including 29 with surgery followed by radiotherapy (11 with intensity-modulated radiotherapy (IMRT) and 18 with stereotactic radiosurgery (SRS)) and 37 with surgery alone. Chi-square test was used to compare the clinical characteristic between the groups. The Kaplan-Meier method was used to analyze overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox proportional hazards models were used to examine prognostic factors of survival. We also underwent a matched-pair analysis by using the propensity score method.ResultsThe crude local control rates were 58.6% in the surgery plus post-operative radiotherapy group (PORT) and 67.6% in the surgery alone group (p = 0.453). In the subgroup analysis of the PORT patients, local controls were 72.7% in the IMRT group and 50% in the SRS group (p = 0.228). The median OS in the PORT and surgery groups were 122 months and 98 months, respectively (p = 0.169). The median RFS was 96 months in the PORT group and 72 months in the surgery alone group (p = 0.714). Regarding radiotherapy technique, the median OS and RFS of the SRS group were not significantly different from those in the IMRT group (p = 0.256, 0.960). The median RFS were 112 and 72 months for pathology grade II and III patients, respectively (p = 0.001). Propensity score matching did not change the observed results.ConclusionIn this retrospective analysis, PORT did not improve the local control rates nor the survivals. The local control rates after IMRT and SRS were similar even though the IMRT technique had a much higher biological dose compared with the SRS technique.

Highlights

Intracranial hemangiopericytoma is a rare disease and surgery is the mainstay treatment
The local control rates after intensity-modulated radiotherapy (IMRT) and stereotactic radiosurgery (SRS) were similar even though the IMRT technique had a much higher biological dose compared with the SRS technique
Patients and radiotherapy techniques A total of 66 patients diagnosed with intracranial HPC were collected (Table 1)

Summary

Introduction

Intracranial hemangiopericytoma is a rare disease and surgery is the mainstay treatment. The purpose of this study is to analyze the impact of post-operative radiotherapy and different radiotherapy technique on the results in patients with intracranial hemangiopericytoma (HPC). In 1942, Stout AP and Margaret RM described a new type of vascular tumor showing the characteristic formation of endothelial tubes and sprouts surrounded by a sheath of rounded and sometimes elongated cells. They believed that these cells were derived from the capillary pericytes and suggested that the tumors be called hemangiopericytoma (HPC) [1]. The histological origin of central nervous system HPC has been controversial for a long time, and it is widely accepted that this tumor arises from the meningeal capillary pericytes. The current WHO classification includes HPC in the group of meningeal mesenchymal non-meningothelial tumors with uncertain malignant potential or borderline malignancy [11,12,13]

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