Efficacy of adjuvant radiotherapy in the intracranial hemangiopericytoma

  • Seung Hyuck Jeon
  • Sung-Hye Park
  • Jin Wook Kim
  • Chul-Kee Park
  • Sun Ha Paek
  • Il Han Kim
Clinical Study

Abstract

We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40). The median follow-up period was 50 months (range 3–216 months). The local recurrence was defined as intracranial relapse within 15 mm and regional recurrence as beyond 15 mm from the margin of surgical bed. The 10-year overall survival (OS) and progression-free survival (PFS) were 69.9 and 34.4%, respectively. The 10-year local, regional, and distant failure-free rates were 56.6, 88.2, and 73.3%, respectively. Local tumor control was better with GTR followed by RT than GTR alone (p = 0.056), while there was no difference in OS. Local tumor control and OS after STR plus RT were equivalent to those after GTR alone. There were no differences in distant metastasis-free survival (DMFS) among GTR plus RT, GTR alone, and STR plus RT. Tumor volume > 40 cm3 was associated with poor PFS (p = 0.024). The local tumor recurrence was reduced by adjuvant RT after surgery. But OS or DMFS was not improved with adjuvant RT. PFS was better in the tumor with small volume at diagnosis.

Keywords

Hemangiopericytoma Radiotherapy Radiosurgery Tumor volume 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stout AP, Murray MR (1942) Hemangiopericytoma: a vascular tumor featuring Zimmermann’s pericytes. Ann Surg 116:26–33CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Park MS, Araujo DM (2009) New insights into the hemangiopericytoma/solitary fibrous tumor spectrum of tumors. Curr Opin Oncol 21:327–331CrossRefPubMedGoogle Scholar
  3. 3.
    Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Brunori A, Delitala A, Oddi G, Chiappetta F (1997) Recent experience in the management of meningeal hemangiopericytomas. Tumori 83:856–861PubMedGoogle Scholar
  5. 5.
    Rutkowski MJ, Jian BJ, Bloch O, Chen C, Sughrue ME, Tihan T et al (2012) Intracranial hemangiopericytoma: clinical experience and treatment considerations in a modern series of 40 adult patients. Cancer 118:1628–1636CrossRefPubMedGoogle Scholar
  6. 6.
    Schiariti M, Goetz P, El-Maghraby H, Tailor J, Kitchen N (2011) Hemangiopericytoma: long-term outcome revisited. J Neurosurg 114:747–755CrossRefPubMedGoogle Scholar
  7. 7.
    Ghia AJ, Chang EL, Allen PK, Mahajan A, Penas-Prado M, McCutcheon IE et al (2013) Intracranial hemangiopericytoma: patterns of failure and the role of radiation therapy. Neurosurgery 73:624–630CrossRefPubMedGoogle Scholar
  8. 8.
    Melone AG, D’Elia A, Santoro F, Salvati M, Delfini R, Cantore G et al (2014) Intracranial hemangiopericytoma—our experience in 30 years: a series of 43 cases and review of the literature. World Neurosurg 81:556–562CrossRefPubMedGoogle Scholar
  9. 9.
    Zhu H, Duran D, Hua L, Tang H, Chen H, Zhong P et al (2016) Prognostic factors in patients with primary hemangiopericytomas of the central nervous system: a series of 103 cases at a single institution. World Neurosurg 90:414–419CrossRefPubMedGoogle Scholar
  10. 10.
    Rutkowski MJ, Sughrue ME, Kane AJ, Aranda D, Mills SA, Barani IJ et al (2010) Predictors of mortality following treatment of intracranial hemangiopericytoma. J Neurosurg 113:333–339CrossRefPubMedGoogle Scholar
  11. 11.
    Stessin AM, Sison C, Nieto J, Raifu M, Li B (2013) The role of postoperative radiation therapy in the treatment of meningeal hemangiopericytoma-experience from the SEER database. Int J Radiat Oncol Biol Phys 85:784–790CrossRefPubMedGoogle Scholar
  12. 12.
    Sonabend AM, Zacharia BE, Goldstein H, Bruce SS, Hershman D, Neugut AI et al (2014) The role for adjuvant radiotherapy in the treatment of hemangiopericytoma: a Surveillance, Epidemiology, and End Results analysis. J Neurosurg 120:300–308CrossRefPubMedGoogle Scholar
  13. 13.
    Ramakrishna R, Rostomily R, Sekhar L, Rockhill J, Ferreira M (2014) Hemangiopericytoma: radical resection remains the cornerstone of therapy. J Clin Neurosci 21:612–615CrossRefPubMedGoogle Scholar
  14. 14.
    Ghose A, Guha G, Kundu R, Tew J, Chaudhary R (2017) CNS hemangiopericytoma: a systematic review of 523 patients. Am J Clin Oncol 40:223–227CrossRefPubMedGoogle Scholar
  15. 15.
    Lee EJ, Kim JH, Park ES, Khang SK, Cho YH, Hong SH et al (2016) The impact of postoperative radiation therapy on patterns of failure and survival improvement in patients with intracranial hemangiopericytoma. J Neurooncol 127:181–190CrossRefPubMedGoogle Scholar
  16. 16.
    DeLaney TF, Park L, Goldberg SI, Hug EB, Liebsch NJ, Munzenrider JE et al (2005) Radiotherapy for local control of osteosarcoma. Int J Radiat Oncol Biol Phys 61:492–498CrossRefPubMedGoogle Scholar
  17. 17.
    Mendenhall WM, Morris CG, Amdur RJ, Foote KD, Friedman WA (2003) Radiotherapy alone or after subtotal resection for benign skull base meningiomas. Cancer 98:1473–1482CrossRefPubMedGoogle Scholar
  18. 18.
    York JE, Kaczaraj A, Abi-Said D, Fuller GN, Skibber JM, Janjan NA et al (1999) Sacral chordoma: 40-year experience at a major cancer center. Neurosurgery 44:74–79CrossRefPubMedGoogle Scholar
  19. 19.
    Damodaran O, Robbins P, Knuckey N, Bynevelt M, Wong G, Lee G (2014) Primary intracranial haemangiopericytoma: comparison of survival outcomes and metastatic potential in WHO grade II and III variants. J Clin Neurosci 21:1310–1314CrossRefPubMedGoogle Scholar
  20. 20.
    Methieu D (2016) Why do hemangiopericytomas have such high recurrence rates? Expert Rev Anticancer Ther 16:1095–1096CrossRefGoogle Scholar
  21. 21.
    Demicco EG, Park MS, Araujo DM, Fox PS, Bassett RL, Pollock RE et al (2012) Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model. Mod Pathol 25:1298–1306CrossRefPubMedGoogle Scholar
  22. 22.
    Chiechi MV, Smirniotopoulos JG, Mena H (1996) Intracranial hemangiopericytomas: MR and CT features. AJNR Am J Neuroradiol 17:1365–1371PubMedGoogle Scholar
  23. 23.
    Pang H, Yao Z, Ren Y, Liu G, Zhang J, Feng X (2015) Morphologic patterns and imaging features of intracranial hemangiopericytomas: a retrospective analysis. Onco Targets Ther 8:2169–2178PubMedPubMedCentralGoogle Scholar
  24. 24.
    Trabelsi S, Mama N, Chourabi M, Mastouri MH, Ladib M, Popov S et al (2015) Meningeal hemangiopericytomas and meningomas: a comparative immunohistochemical and genetic study. Asian Pac J Cancer Prev 16:6871–6876CrossRefPubMedGoogle Scholar
  25. 25.
    Choi J, Park SH, Khang SK, Suh YL, Kim SP, Lee YS et al (2016) Hemangiopericytomas in the central nervous system: a multicenter study of Korean cases with validation of the usage of STAT6 immunohistochemistry for diagnosis of disease. Ann Surg Oncol 23:954–961CrossRefPubMedGoogle Scholar
  26. 26.
    Rajaram V, Brat DJ, Perry A (2004) Anaplastic meningioma versus meningeal hemangiopericytoma: immunohistochemical and genetic markers. Hum Pathol 35:1413–1418CrossRefPubMedGoogle Scholar
  27. 27.
    Kim JW, Kim DG, Chung HT, Paek SH, Kim YH, Han JH et al (2010) Gamma Knife stereotactic radiosurgery for intracranial hemangiopericytomas. J Neurooncol 99:115–122CrossRefPubMedGoogle Scholar
  28. 28.
    Copeland WR, Link MJ, Stafford SL, Pollock BE (2014) Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas. J Neurooncol 120:95–102CrossRefPubMedGoogle Scholar
  29. 29.
    Olson C, Yen CP, Schlesinger D, Sheehan J (2010) Radiosurgery for intracranial hemangiopericytomas: outcomes after initial and repeat Gamma Knife surgery. J Neurosurg 112:133–139CrossRefPubMedGoogle Scholar
  30. 30.
    Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford LD (2008) Adjuvant stereotactic radiosurgery after resection of intracranial hemangiopericytomas. Int J Radiat Oncol Biol Phys 72:1333–1339CrossRefPubMedGoogle Scholar
  31. 31.
    Cohen-Inbar O, Lee CC, Mousavi SH, Kano H, Mathieu D, Meola A et al (2017) Stereotactic radiosurgery for intracranial hemangiopericytomas: a multicenter study. J Neurosurg 126:744–754CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologySeoul National University HospitalSeoulSouth Korea
  2. 2.Department of PathologySeoul National University HospitalSeoulSouth Korea
  3. 3.Department of NeurosurgerySeoul National University HospitalSeoulSouth Korea
  4. 4.Cancer Research InstituteSeoul National University College of MedicineSeoulSouth Korea

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