The role of radiosurgery for hemangiopericytomas

Chang, Steven D.; Sakamoto, Gordon T.

doi:10.3171/foc.2003.14.5.15

Cited by 58 publications

(53 citation statements)

References 33 publications

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“…Two groups reported that radiotherapy after an initial resection extended the mean time to local recurrence from 34 to 75 months and extended overall survival from 62 to 92 months. 6,12 Dufour et al 7 reported in their series that HPCs recurred after an average interval of 74 months if they were subjected to irradiation after the first surgical treatment, as compared with an average of 29 months if they were not treated with radiotherapy after initial resection.…”

Section: Multimodal Managementmentioning

confidence: 99%

“…24 Even most HPCs treated with GTR and adjuvant SRT tend to locally recur by 6 years after treatment. 6,12 However, cases of local recurrence and distal metastases have been reported more than 20 years out from the initial diagnosis. Therefore, long-term follow-up with annual serial imaging is suggested for optimal management.…”

Section: Multimodal Managementmentioning

confidence: 99%

“…Gamma knife radiation has occasionally been used as an upfront therapy for the treatment of HPC, and the literature supports a role for this treatment in recurrent lesions, as disease-free survival tends to be higher in cases of newly diagnosed HPCs treated with a combination of resection and adjuvant postoperative SRT. 6,12 Sheehan et al 26 demonstrated in a series of 14 patients with 15 HPCs treated with radiosurgery, 7 of which had been subjected to radiotherapy, an 80% local control rate for recurrent intracranial HPCs using Gamma Knife surgery, with a median time to local recurrence of 21 months. Authors of this study also demonstrated Kaplan-Meier survival rates of 76% and 100% 5 years after Gamma Knife surgery but reported remote metastases in 29% of the patients, and thus concluded that local tumor control afforded by radiosurgery provided seemingly little protection from distant metastases.…”

Section: Multimodal Managementmentioning

confidence: 99%

“…Unfortunately, although the addition of either SRT or SRS seems to confer superior local control over surgery alone, these therapies do not appear to provide any significant protection against the development of distant metastases. 6,26 In patients with advanced, symptomatic extracranial HPC, radiotherapy may also play an important palliative role. Based on the data summarized in Olson et al 23 it appears that a higher margin dose of at least 18-20 Gy should be recommended to avoid early recurrence.…”

Section: Multimodal Managementmentioning

confidence: 99%

“…7,[11][12][13]21,25 The response of HPCs to radiotherapy is dose dependent, with overall treatment doses of 45 Gy or higher resulting in superior local control. 6 The current SRT treatment plan used in most centers delivers 46-52 Gy fractionated over [25][26][27][28][29][30][31][32][33][34][35] sessions. In recent years, SRT has emerged as a viable salvage strategy for the treatment of recurrent intracranial HPCs, ideally less than 3 cm in their greatest dimension.…”

Section: Multimodal Managementmentioning

confidence: 99%

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Hemangiopericytomas of the skull base

Schirmer¹,

Heilman²

2011

FOC

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Object Intracranial hemangiopericytomas are frequently located along the dural sinuses along the skull base and represent rare, aggressive CNS neoplasms that are difficult to distinguish from meningiomas based on both imaging and gross characteristics. The authors of this study describe 3 patients with these lesions and review the pertinent literature. Methods Two men and 1 woman, whose median age at the time of the initial presentation was 37 years (range 20–53 years), constitute this series. They underwent multimodal treatment consisting of resection, embolization, radiation therapy, and in 1 case chemotherapy. Results Two of the 3 patients treated were alive after a mean follow-up of 93 months (range 4–217 months). One patient died 217 months after the initial diagnosis. The longest tumor progression–free interval after the initial or secondary resection was 43 months (range 4–84 months). Conclusions Hemangiopericytomas have been reclassified as mesenchymal nonmeningothelial tumors. They have an inevitable tendency to recur locally and metastasize distally. The mainstay of therapy remains an aggressive attempt to achieve gross-total resection at the initial surgery. Postoperative adjuvant radiotherapy should be offered to all patients, regardless of the degree of resection achieved. Diligent long-term follow-up is paramount as local recurrences and distal metastases can develop sometimes years after the initial treatment.

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Section: Multimodal Managementmentioning

confidence: 99%

Section: Multimodal Managementmentioning

confidence: 99%

Section: Multimodal Managementmentioning

confidence: 99%

Section: Multimodal Managementmentioning

confidence: 99%

Section: Multimodal Managementmentioning

confidence: 99%

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Hemangiopericytomas of the skull base

Schirmer¹,

Heilman²

2011

FOC

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Central Nervous System and Peripheral Nerves

Ormond

Bouras

Moore

et al. 2018

The American Cancer Society's Oncology in Practice

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Intracranial meningeal hemangiopericytoma: The role of radiotherapy

Soyuer

Chang

Selek

et al. 2004

Cancer

168

129

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BACKGROUND The current retrospective study was undertaken to evaluate the treatment outcomes of patients with meningeal hemangiopericytoma (M‐HPC), to define the role of radiotherapy in the management of the disease, and to report on the patterns of failure. METHODS The medical records of 29 patients with nonmetastatic M‐HPC treated at The University of Texas M. D. Anderson Cancer Center (Houston, TX) between August 1979 and March 1999 were reviewed. Fifteen patients (52%) underwent macroscopic total resection (‘gross total resection’ [GTR]), 10 (34%) underwent subtotal resection (STR), and 4 (14%) had unknown extent of surgery. Ten of 24 patients received adjuvant radiotherapy. RESULTS The 5, 10, and 15‐year overall survival rates were 85%, 68%, and 43%, respectively. The local control rates at 5 and 10 years were 68% and 22%, respectively. Two patients experienced disease recurrence at another intracranial site. Sixteen patients (55%) developed extraneural metastases. Four patients (14%) developed spinal metastases. The 5‐, 10‐, and 15‐year distant metastasis–free survival rates were 80%, 46%, and 21%, respectively. The 5‐year local control rates for patients treated with GTR and STR were 84% and 38%, respectively (P = 0.003). Of the 15 patients treated with GTR, 3 received adjuvant radiotherapy as part of their initial treatment. Malignant disease did not recur locally in these three patients. However, the effect of the adjuvant radiotherapy on local control was not statistically significant. CONCLUSIONS M‐HPCs can recur locally or distantly in the neural axis or as extraneural distant metastases. Based on literature review and the patterns of failure in the current series, attempting to perform GTR followed by limited‐field radiotherapy appeared to represent a reasonable approach for the initial management of M‐HPC. Cancer 2004;100:1491–7. © 2004 American Cancer Society.

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The role of radiosurgery for hemangiopericytomas

Cited by 58 publications

References 33 publications

Hemangiopericytomas of the skull base

Hemangiopericytomas of the skull base

Central Nervous System and Peripheral Nerves

Intracranial meningeal hemangiopericytoma: The role of radiotherapy

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