Gamma Knife stereotactic radiosurgery for intracranial hemangiopericytomas

Kim, Jin Wook; Kim, Dong Gyu; Chung, Hyun‐Tai; Paek, Sun Ha; Kim, Yong Hwy; Han, Jung Ho; Park, Shin Young; Kim, Chae-Yong; Jung, Hee-Won

doi:10.1007/s11060-010-0114-z

Cited by 33 publications

(26 citation statements)

References 18 publications

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“…In contrast, radiosurgery for patients with atypical meningiomas could be one of the treatment options; however, this still showed unsatisfactory results. Given the malignant characteristics of atypical meningiomas, the delivery of a higher marginal dose could be a feasible therapeutic strategy for achieving better local tumor control [12,25,26,27]. However, we could not determine the optimal dose or timing for achieving successful tumor control without causing adverse radiation effects in the current study.…”

Section: Discussionmentioning

confidence: 94%

Radiosurgery for Atypical and Anaplastic Meningiomas: Histopathological Predictors of Local Tumor Control

Kim¹,

Kim²,

Paek³

et al. 2012

Stereotact Funct Neurosurg

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Objectives: We investigated the radiosurgical outcomes of patients with nonbenign meningiomas retrospectively and sought to identify prognostic factors for local tumor control after radiosurgery with an emphasis on histopathology. Methods: Between 1998 and 2010, 35 patients with 49 atypical or anaplastic meningiomas were treated with radiosurgery. The mean tumor volume and marginal irradiation dose were 3.5 cm³ (range 0.3–25.3) and 16 Gy (range 12–21), respectively. Results: The actuarial local tumor control rates for patients with atypical meningiomas at 1, 2 and 3 years after radiosurgery were 78, 53 and 36%, respectively, whereas those for anaplastic meningiomas were 35% at 1 year and 10% at 2 years. Multivariate analysis revealed that the mitotic count (≤8 per 10 high-power fields; HPF) and the MIB-1 proliferation marker labeling index (LI; ≤8%) were significant favorable prognostic factors for the radiosurgical outcomes of patients with nonbenign meningiomas (p = 0.014 and p = 0.012, respectively). Conclusions: Radiosurgery could be a treatment option for patients with atypical meningiomas, but more aggressive treatments are needed for those with anaplastic meningiomas. Histopathological factors such as mitotic count and MIB-1 LI are significant prognostic factors for the radiosurgical outcomes of patients with nonbenign meningiomas and should be considered before radiosurgery.

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Section: Discussionmentioning

confidence: 94%

Radiosurgery for Atypical and Anaplastic Meningiomas: Histopathological Predictors of Local Tumor Control

Kim¹,

Kim²,

Paek³

et al. 2012

Stereotact Funct Neurosurg

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“…There are no conclusive dose was recommended currently for HPC, it was reported a median total dose of 54 Gy was delivered in a routine fractionation, the overall survival rates at 5 and 10 years are 100% and 64%, respectively [6]. It's reported that the response of HPCs to radiotherapy is dose dependent, with overall dose of 45 Gy or higher resulting in superior local control [19,20]. The role of chemotherapy in the treatment of systemic HPC is unclear; however, some patients have demonstrated modest benefit from chemotherapeutic regimens [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…A study suggested that chemotherapy has a positive effect for patients with recurrence of HPC, but large sample study and long-term observation should be carried out [24]. In addition to their propensity for local recurrence, HPCs also metastasize outside the CNS, it's reported that the average time to local recurrence is from 12 to 47 months, and the average time to development of extra-cranial metastases ranges from 63 to 99 months after initial surgical resection, and the most common sites of distant metastases are bone, liver, lung, and the skeletal muscle, but early systemic metastasis is very rare [19,25,26]. Radiotherapy shows promise in preventing local tumour progression, but recurrence sometimes still remains a common treatment outcome, adjuvant postoperative radiation is an attractive option for surgical remaining tumour [6,7,15,16,18,[26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Effect of Adjuvant Radiotherapy in the Management of Hemangiopericytoma of the Central Nervous System:Report of 5 Cases

Sun¹

2014

J Nucl Med Radiat Ther

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Objective: Primary intracranial or spinal hemangiopericytoma (HPC) represents a rare tumour that is more difficult to distinguish from other CNS tumours based on clinical symptoms and imaging findings. In this article, here we present 5 cases with HPC (3 intracranial and 2 spinal) with histologically confirmed were treated at our hospital between June 2009 to January 2010, and a review of the literature pertaining to the diagnosis, clinical management, and so on.Methods: Clinical data of the 5 patients with HPCs from cerebra and spinal cord including the manifestations of imaging, pathology, treatment and prognosis factors were investigated, and relevant literatures were reviewed. Of which, 3 males, 2 females, age ranged from 6-35 years old, median age at primary diagnosis was 29 years.Results: 3 patients underwent craniotomy and the other 2 patients underwent spinal surgery. Total mass removal was achieved in 1 case and subtotal removal in 4 cases. All 5 patients received radiotherapy after resection, A total dose of 59.4 Gy/33f was delivered in a fractionation of 5 x1.8 Gy per week for the 3 patients with cerebral lesions using three dimensional conformal radiation therapy (3D-CRT) or intensive modulated radiation therapy (IMRT) technique, and 45Gy in 25 fractions for the 2 patients with spinal lesions. The patients were followed up varied from 6 to 27 months, and none of the patients was found with evidence of radiation complications. Acute toxicity was mild including skin erythema and alopecia. Follow-up of the patients has not yet discovered that a tumour recurrence and extra-cranial metastasis all remain alive up to date. Conclusions:Multidisciplinary care should be highly advocated in the management of intracranial or spinal HPC. Surgical resection, either complete or subtotal excision, followed by postoperative radiotherapy, will provide the patients with higher probability for disease-free survival.

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“…Nine of 9 tumors with follow-up imaging were controlled at a mean follow-up of 14.8 months. Since Coffey et al first reported on the use of SRS for the treatment of M-HPC, a number of institutional series have been published on this topic [8,[21][22][23][24][25][26]. LTC rates at 1-, 3-, and 5-years in these studies have varied from 89 to 100, 60 to 84, and 29 to 72 %, respectively.…”

Section: Radiosurgery For Meningeal Hemangiopericytomasmentioning

confidence: 99%

“…To date, chemotherapy has generally proven to be ineffective for patients with M-HPC [15][16][17]. Over the past 25 years, stereotactic radiosurgery (SRS) has been utilized for patients with residual or recurrent intracranial M-HPC [16,[18][19][20][21][22][23][24][25][26]. The purpose of the present study was to review the Follow-up MRI and clinical evaluations were typically obtained at 3, 6, and 12 months, and then yearly from the time of SRS if the patient and imaging were stable up to that point.…”

Section: Introductionmentioning

confidence: 99%

Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas

et al. 2014

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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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Gamma Knife stereotactic radiosurgery for intracranial hemangiopericytomas

Cited by 33 publications

References 18 publications

Radiosurgery for Atypical and Anaplastic Meningiomas: Histopathological Predictors of Local Tumor Control

Radiosurgery for Atypical and Anaplastic Meningiomas: Histopathological Predictors of Local Tumor Control

Effect of Adjuvant Radiotherapy in the Management of Hemangiopericytoma of the Central Nervous System:Report of 5 Cases

Single-fraction stereotactic radiosurgery of meningeal hemangiopericytomas

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