Gamma knife radiosurgery for residual or recurrent intracranial hemangiopericytomas. (January 2017)

• Record Type: Journal Article
• Authors: Kim, Byung Sup; Kong, Doo-Sik; Seol, Ho Jun; Nam, Do-Hyun; Lee, Jung-Il
• Is Part Of: Journal of clinical neuroscience. Volume 35(2017:Jan.)
• Page Start: 35
• Page End: 41
• Publication Date: 2017-01
• Subjects: Hemangiopericytoma -- Gamma knife -- Radiosurgery -- Extracranial metastasis; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2016.10.002
• Languages: English
• ISSNs: 0967-5868

Abstract

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.