Multimodal treatment and management strategies for intracranial hemangiopericytoma

J Clin Neurosci. 2015 Apr;22(4):718-25. doi: 10.1016/j.jocn.2014.11.011. Epub 2015 Mar 3.

Abstract

Intracranial hemangiopericytoma (HPC) is a rare malignant meningothelial tumor. The authors retrospectively reviewed the long-term clinical outcomes of patients with HPC with regard to treatment modalities and histopathological grades. Eighteen women and 20 men (mean age 38.5 years, range, 18-62 years) were observed over an average follow-up period of 61 months (range, 15-133 months) between 2003 and 2013. The initial treatment modalities included total tumor resection followed by conventional radiotherapy (RT) (n=27), and subtotal tumor resection followed by stereotactic radiosurgery (n=11). One patient (3%) had permanent neurological deficits, and six patients (16%) died. Thirteen patients (34%) suffered recurrence. One year, 5 year, and 10 year recurrence-free survival rates were 100%, 70%, and 39%, respectively. Five patients (13%) developed metastasis. One year, 5 year, and 10 year metastasis-free survival rates were 100%, 89%, 74%, respectively. Low grade tumors were associated with longer overall survival, recurrence-free interval and metastasis-free interval (log-rank, p<0.05). Radical resection with RT was associated with longer overall survival and recurrence-free interval (log-rank, p<0.05), but had no effect on the metastasis-free interval (log-rank, p=0.245). Thus, radical surgery followed by adjuvant RT is the primary treatment of HPC, but recurrence and metastasis remain a common treatment outcome regardless of initial strategy. It is necessary to maintain long-term follow-up and serial imaging for all patients with intracranial HPC after treatment, regardless of extent of resection.

Keywords: Hemangiopericytoma; Radiotherapy; Recurrence; Surgery; Survival.

MeSH terms

  • Adolescent
  • Adult
  • Brain Neoplasms / mortality
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Diagnostic Imaging
  • Female
  • Hemangiopericytoma / mortality
  • Hemangiopericytoma / radiotherapy
  • Hemangiopericytoma / surgery
  • Hemangiopericytoma / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Recurrence, Local / therapy*
  • Radiosurgery
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult