TY - JOUR
T1 - Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas
AU - Copeland, William R.
AU - Link, Michael J.
AU - Stafford, Scott L.
AU - Pollock, Bruce E.
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York.
PY - 2014/9/27
Y1 - 2014/9/27
N2 - 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.
AB - 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.
KW - Hemangiopericytoma
KW - Radiation
KW - Stereotactic radiosurgery
KW - Treatment
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U2 - 10.1007/s11060-014-1521-3
DO - 10.1007/s11060-014-1521-3
M3 - Article
C2 - 25005529
AN - SCOPUS:84910112815
SN - 0167-594X
VL - 120
SP - 95
EP - 102
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 1
ER -