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Treatment Strategy of Intracranial Hemangiopericytoma
#MMPMID26605260
Kim YJ
; Park JH
; Kim YI
; Jeun SS
Brain Tumor Res Treat
2015[Oct]; 3
(2
): 68-74
PMID26605260
show ga
BACKGROUND: Recent studies suggest aggressive management combining a grossly
total resection (GTR) with adjuvant radiotherapy (RT) as a treatment of choice
for intracranial hemangiopericytoma (HPC). However, in these papers, the
definitions of complete or GTR are equivocal. In the present study, we reviewed
the relevant cases from our experience focused on the clinical efficacy of
surgical grading of resection, and analyzed the optimal treatment strategies as
well. METHODS: From January 1995 through December 2014, 17 patients treated for
intracranial HPC were included in this study. We analyzed clinical presentation,
radiologic appearance, pathologic diagnosis, extent of resection, and follow-up
outcomes. RESULTS: A total of 26 operations were performed including 9 recurrent
intracranial HPCs. Every tumor was single and had no evidence of metastasis. Most
common area of tumor was parasagittal (8 patients, 47.1%), which is adjoined to
superior sagittal sinus. For the initial operation, GTR was performed in 16 cases
(61.5%), partial resection (PR) in 8 cases (30.8%), and an endoscopic biopsy in 2
patients (7.7%). In Simpson grading system, grade 1 was done in 2 patients
(7.7%), grade 2 in 11 patients (42.3%) and grade 3 in 3 patients (11.5%).
Postoperative RT was delivered in 16 patients (94.1%) regardless of the extent of
resection. The median 57.57 Gy (range, 50-60 Gy) was delivered in median 33
fractions (range, 30-40). The extent of resection (conventional classification
and Simpson grading system) and adjuvant RT were significantly associated with
recurrence-free survival. CONCLUSION: Surgical resection of intracranial HPC, in
an attempt to reach Simpson grade 1 removal, is necessary for better outcome.
Adjuvant RT should be done as recommended before, to prevent recurrence,
regardless of surgical resection and pathological diagnosis.
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