Abstract
PurposeHemangiopericytomas are aggressive tumors known for their recurrence. The purpose of this study was to evaluate the management of residual, recurrent, and metastatic intracranial hemangiopericytomas using CyberKnife (CK) stereotactic radiotherapy (SRT).Materials and MethodsData were collected from 15 patients (28 tumors; eight men and seven women; 32–58 years) with residual, recurrent, or metastatic intracranial hemangiopericytomas, who were treated with stereotactic radiotherapy using CyberKnife between January 2014 and August 2019. All patients had previously been treated with surgical resection. Initial tumor volumes ranged from 0.84 to 67.2 cm3, with a mean volume of 13.06 cm3. The mean marginal and maximum radiosurgical doses to the tumors were 21.1 and 28.76 Gy, respectively. The mean follow-up time for tumors was 34.5 months, ranging from 13 to 77 months.Results15 patients were alive after treatment; the mean post-diagnosis survival at censoring was 45.6 months (range 13–77 months). The volumes of the 28 tumors in the 15 followed patients were calculated after treatment. Postoperative magnetic resonance imaging revealed a mean tumor volume of 6.72 cm3 and a range of 0–67.2 cm3, with the volumes being significantly lower than pretreatment values. Follow-up imaging studies demonstrated tumor disappearance in seven (25%) of 28 tumors, reduction in 14 (50%), stability in one (3.57%), and recurrence in six (21.4%). Total tumor control was achieved in 22 (78.5%) of 28 tumors. The tumor grade and fraction time were not significantly associated with progression-free survival. Intracranial metastasis occurred in three patients, and extraneural metastasis in one patient.ConclusionsOn the basis of the current results, stereotactic radiotherapy using CyberKnife is an effective and safe option for residual, recurrent, and metastatic intracranial hemangiopericytomas. Long-term close clinical and imaging follow-up is also necessary.
Highlights
Hemangiopericytomas (HPCs) are rare tumors that exhibit a high incidence of local recurrence and distant metastasis, even after gross-total resection [1]
Written informed consent was obtained from each participant prior to study inclusion, and the study was approved by the local ethics committee of our institute (No S2018-119-01)
All patients were previously treated with surgical resection and had histopathologically confirmed diagnoses
Summary
Hemangiopericytomas (HPCs) are rare tumors that exhibit a high incidence of local recurrence and distant metastasis, even after gross-total resection [1]. Central nervous systems HPCs are uncommon, accounting for only 0.4% of all primary intracranial tumors and 2.4% of meningeal tumors [2]. Central nervous system (CNS) HPC usually occurs in adults with an average diagnostic age between 40 and 50 years [3]. Epidemiology, and end results in 655 patients and a review of CNS [199] and extra-CNS HPCs [456] showed 5- and 10-year overall survival rates of 80 and 54%, respectively. Patients with extracranial HPCs had worse outcomes, with 5- and 10-year overall survival rates of 58 and 44%, respectively [3]
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