Artikel
Gamma knife radiosurgery for residual or recurrent intracranial hemangiopericytomas
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Residual or recurrent hemangiopericytoma (HPC) has been treated with radiosurgery; however, its long-term outcome is not well known.
Method: We conducted a retrospective analysis of 18 patients who underwent gamma knife radiosurgery (GKS) for residual or recurrent HPCs.
Results: 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 94.4, 85.9, and 58.0%, respectively. At the last follow-up, intracranial tumor control was achieved in 12 (66.7%) of 18 patients. New lesions developed out of initial GKS target in 8 patients (44.4%). They were also treated with additional GKS and a total of 40 tumors were treated. The actuarial local control rate of 40 tumors at 1, 3, and 5 years was 89.0, 66.9, and 46.1%, 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 = 0.004). Extracranial metastases developed in 7 (38.9%) patients with high-grade pathology and became a cause of death in 3 patients.
Conclusions: 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.