Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas

William R. Copeland, Michael J. Link, Scott L. Stafford, Bruce E. Pollock

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Meningeal hemangiopericytomas (M-HPC) are challenging tumors with a high rate of recurrence despite surgical resection and external beam radiotherapy (EBRT). To better understand the role of single-fraction stereotactic radiosurgery (SRS) for patients with M-HPC, we reviewed our experience with 22 patients (12 men, 10 women) from 1990 until 2010. Twelve patients (55 %) underwent a single SRS procedure, whereas 10 patients (45 %) had more than one SRS procedure (range 2–6). In total, 47 SRS procedures were performed to treat 64 tumors. Fourteen patients (64 %) had undergone prior EBRT (median dose, 56.0 Gy). Follow-up after the initial SRS (median, 66 months) was censored at the time of death (n = 15) or last clinical evaluation (n = 7). Eleven patients (50 %) died of intracranial tumor progression (n = 10) or treatment-related complications (n = 1). One patient (5 %) died of systemic disease progression. Disease-specific survival (DSS) at 1-, 3- and 5-years after SRS was 96, 82, and 61 %, respectively. Prior EBRT (HR 9.0, 95 % CI 1.1–78.1, p < 0.05) and larger initial tumor volume (HR 1.09, 95 % CI 1.02–1.2, p = 0.02) were associated with worse DSS. Local tumor control (LTC) after SRS at 1-, 3-, and 5-years was 89, 68, and 59 %, respectively. Improved LTC was noted in patients who had not undergone prior EBRT (HR 6.3, 95 % CI 2.1–19.5, p = 0.001). One patient (5 %) had symptomatic radiation-relation complications after SRS. Overall, single-fraction SRS was effective in providing LTC for more than half of recurrent or residual M-HPC at 5-years after the procedure. Repeat SRS is often required secondary to either distant or local tumor progression.

Original languageEnglish (US)
Pages (from-to)95-102
Number of pages8
JournalJournal of Neuro-Oncology
Volume120
Issue number1
DOIs
StatePublished - Sep 27 2014

Fingerprint

Hemangiopericytoma
Radiosurgery
Radiotherapy
Neoplasms
Survival
Tumor Burden
Disease Progression
Radiation

Keywords

  • Hemangiopericytoma
  • Radiation
  • Stereotactic radiosurgery
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology
  • Medicine(all)

Cite this

Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas. / Copeland, William R.; Link, Michael J.; Stafford, Scott L.; Pollock, Bruce E.

In: Journal of Neuro-Oncology, Vol. 120, No. 1, 27.09.2014, p. 95-102.

Research output: Contribution to journalArticle

Copeland, William R. ; Link, Michael J. ; Stafford, Scott L. ; Pollock, Bruce E. / Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas. In: Journal of Neuro-Oncology. 2014 ; Vol. 120, No. 1. pp. 95-102.
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abstract = "Meningeal hemangiopericytomas (M-HPC) are challenging tumors with a high rate of recurrence despite surgical resection and external beam radiotherapy (EBRT). To better understand the role of single-fraction stereotactic radiosurgery (SRS) for patients with M-HPC, we reviewed our experience with 22 patients (12 men, 10 women) from 1990 until 2010. Twelve patients (55 {\%}) underwent a single SRS procedure, whereas 10 patients (45 {\%}) had more than one SRS procedure (range 2–6). In total, 47 SRS procedures were performed to treat 64 tumors. Fourteen patients (64 {\%}) had undergone prior EBRT (median dose, 56.0 Gy). Follow-up after the initial SRS (median, 66 months) was censored at the time of death (n = 15) or last clinical evaluation (n = 7). Eleven patients (50 {\%}) died of intracranial tumor progression (n = 10) or treatment-related complications (n = 1). One patient (5 {\%}) died of systemic disease progression. Disease-specific survival (DSS) at 1-, 3- and 5-years after SRS was 96, 82, and 61 {\%}, respectively. Prior EBRT (HR 9.0, 95 {\%} CI 1.1–78.1, p < 0.05) and larger initial tumor volume (HR 1.09, 95 {\%} CI 1.02–1.2, p = 0.02) were associated with worse DSS. Local tumor control (LTC) after SRS at 1-, 3-, and 5-years was 89, 68, and 59 {\%}, respectively. Improved LTC was noted in patients who had not undergone prior EBRT (HR 6.3, 95 {\%} CI 2.1–19.5, p = 0.001). One patient (5 {\%}) had symptomatic radiation-relation complications after SRS. Overall, single-fraction SRS was effective in providing LTC for more than half of recurrent or residual M-HPC at 5-years after the procedure. Repeat SRS is often required secondary to either distant or local tumor progression.",
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