Highlights
- •GKS is an effective treatment for residual or recurrent intracranial hemangiopericytomas (HPC).
- •GKS can achieve the favorable local control in low- and high-grade HPC.
- •Extracranial metastasis is a common cause of death, particularly in high-grade HPC.
Abstract
Residual or recurrent hemangiopericytoma (HPC) has been treated with radiosurgery;
however, its long-term outcome is not well known. This study is to investigate the
long-term outcome of gamma knife radiosurgery (GKS) for residual or recurrent HPCs.
We conducted a retrospective analysis of 18 patients who underwent gamma knife radiosurgery
for residual or recurrent HPCs. Of the 18 patients, 10 patients had high-grade HPCs
(27 tumors) and 8 had low-grade HPCs (13 tumors). Median overall survival (OS) after
the first GKS was 134.7 months and actuarial survival rate at 1, 5, and 10 years was 85.6%, 85.6%, and 37.4%, respectively. At the last follow-up, local tumor
control was achieved in 32 (80.0%) of the 40 GKS-treated tumors. New lesions developed
out of initial GKS target in 8 patients (44.4%). They were also treated with additional
GKS. The actuarial local control rate of 40 tumors at 1-, 3-, and 5-years was 89.3%,
60.9%, and 37.5%, respectively. The median local recurrence-free interval of 40 tumors
after initial GKS for each lesion was 86.1 months for low-grade and 40.5 months for high-grade tumors (p = 0.010). Extracranial metastases developed in 7 (38.9%) patients with high-grade pathology
and became a cause of death in 3 patients. Intracranial tumor control can be achieved
over the long term, though additional GKS is frequently necessary. Extracranial metastasis
is common in HPC of high-grade pathology. Close surveillance and aggressive treatment
is recommended not only for intracranial tumor but also for possible extracranial
metastases.
Keywords
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Article info
Publication history
Published online: October 18, 2016
Accepted:
October 2,
2016
Received:
July 3,
2016
Identification
Copyright
© 2016 Published by Elsevier Ltd.
