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The impact of postoperative radiation therapy on patterns of failure and survival improvement in patients with intracranial hemangiopericytoma

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Abstract

Because of the rarity of intracranial hemangiopericytomas (HPCs), the role of postoperative radiation therapy (PORT) in the management of HPC remains unclear. This study therefore analyzed the effects of PORT on patterns of failure and survival improvement in patients with HPC. Fifty-two patients surgically treated for intracranial HPC at our institution between 1992 and 2013 were retrospectively analyzed. Patterns of failure were subdivided into local recurrence, regional metastasis, and distant metastasis. Multivariate Cox proportional hazards models were used to assess factors prognostic of treatment failure and survival, and a time-dependent Cox proportional hazards models were used to investigate the correlations between patterns of failure and death. Of the 52 patients, 45 (87 %) underwent gross total resection, and 39 (75 %) received PORT. PORT significantly lengthened local control (LC) and overall survival (OS), by 14 and 13 months, respectively, independent of the extent of resection. Patients who did and did not receive PORT had 5 year LC rates of 97 and 44 %, respectively (HR .05, P = .002); and 10 year OS rates of 83 and 25 %, respectively (hazard ratio (HR) .20, P = .008). PORT, however, did not show preventive effects on regional and distant metastases. The main patterns of failure were local recurrence in patients who did not receive PORT and distant metastasis in those who received PORT. Regional metastasis was a main immediate cause of death (P < .001), and tended to occur more frequently and earlier in patients not receiving PORT.

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Acknowledgments

The authors deeply thank to Dr. Rho (Jong-Lyel Roh, M.D., Ph.D., Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea) for kindly reviewing the manuscript and advising on methods to improve it.

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Authors and Affiliations

  1. Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43-gil 88, Songpa-gu, Seoul, 05505, Korea

    Eun Jung Lee, Jeong Hoon Kim, Young Hyun Cho, Seok Ho Hong & Chang Jin Kim

  2. Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Korea

    Eun Suk Park

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43-gil 88, Songpa-gu, Seoul, 05505, Korea

    Shin Kwang Khang

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Correspondence to Jeong Hoon Kim.

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11060_2015_2030_MOESM1_ESM.docx

Kaplan-Meier analyses of overall survival (OS), cause-specific survival (CSS), recurrence-free survival (RFS), local control (LC), regional metastasis-free survival (r-MFS), and distant metastasis-free survival (d-MFS) in patients with WHO grade III HPCs. There was obvious trend toward prolonged OS and CSS in patients receiving PORT. (DOCX 342 kb)

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Lee, E.J., Kim, J.H., Park, E.S. et al. The impact of postoperative radiation therapy on patterns of failure and survival improvement in patients with intracranial hemangiopericytoma. J Neurooncol 127, 181–190 (2016). https://doi.org/10.1007/s11060-015-2030-8

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