The role of radiotherapy in intracranial hemangiopericytoma/solitary fibrous tumors

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dc.authoridDelikgoz Soykut, Ela/0000-0003-1225-8458
dc.authoridKAYDIHAN, NURI/0000-0002-3182-8623
dc.contributor.authorKaydihan, Nuri
dc.contributor.authorYazici, Goezde
dc.contributor.authorErpolat, Petek
dc.contributor.authorKamer, Serra
dc.contributor.authorErdemci, Burak
dc.contributor.authorCanyilmaz, Emine
dc.contributor.authorAtasoy, Beste Melek
dc.date.accessioned2025-05-04T16:47:29Z
dc.date.available2025-05-04T16:47:29Z
dc.date.issued2025
dc.departmentSivas Cumhuriyet Üniversitesi
dc.description.abstractObjectiveIntracranial hemangiopericytomas (HPC) are rare tumors. Radiotherapy (RT) is frequently performed after surgery, depending on tumor size, location, and the type of resection. Moreover, RT is preferred as an effective treatment for local recurrence and metastasis. With this multicenter study, we aimed to investigate the effectiveness of postoperative RT in intracranial HPC patients using modern RT techniques.Materials and methodsPatients aged 16 years and older who underwent RT for histologically confirmed intracranial HPC were evaluated retrospectively. Forty-four patients from 17 institutions were included. Demographic characteristics of the patients, pathological findings, and prognostic factors were documented. The Kaplan-Meier method was used for local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS). The interval for survival analyses was calculated according to the end date of RT. Univariate and multivariate analysis methods were used for factors associated with survival and recurrence.ResultsMedian age was 42 years (16-71) and 70% of the patients were male. The most common initial symptoms were pain (47.7%) and vision problems (15.9%). A supratentorial location was observed in 79.5% of patients. The median maximum tumor dimension was 4.7 (1.6-14) cm. Gross total (GTR) and subtotal resection (STR) were performed in 43.2% and 47.7% of patients, respectively. Adjuvant RT commenced a median of 6 (2-16) weeks after surgery. Postoperative RT was administered using conventionally fractionated intensity-modulated radiotherapy (IMRT) or stereotactic radiosurgery (SRS). A total median dose of 60 (38-66) Gy in a median of 30 (19-33) fractions was used for patients treated with IMRT and a total median dose of 24 (12-25) Gy in a median of 3 (1-5) fractions was used for patients treated with SRS. Local recurrence occurred in 9 patients and locoregional recurrence in 2 patients at a median of 48 months (range 26-143 months) after RT. Reoperation and reirradiation were applied to 5 patients, reirradiation to 4 patients, and reoperation to 2 patients as salvage treatments. Reirradiation was administered at a median dose of 35 (13.5-54) Gy using a median of 5 (1-30) fractions. At a median follow-up of 63 (6-262) months, 5-year LC was 68.7%, DMFS 87.2%, PFS 60.8%, and OS 95.7%. The presence of residual macroscopic tumor before RT was associated with lower LC (p = 0.01) and shorter PFS (p = 0.04). In the presence of residual tumor before RT, 5-year LC decreased from 92.9% to 46.7%, while 5-year PFS decreased from 81.1% to 43.5% compared to patients with GTR. The presence of postoperative tumor was associated with a lower LC rate in Cox regression analyzes (p = 0.02). The hazard ratio was 6.2 (1.2-30). However, the effect of residual disease before RT on OS was not statistically significant.ConclusionAdjuvant radiotherapy is performed in the majority of patients with HPC, especially in cases where GTR cannot be performed. In our study, postoperative macroscopic residual tumor was found to be the only factor affecting LC and PFS in patients undergoing adjuvant RT, but its effect on OS was not shown. This may be due to the effectiveness of reoperation and/or reirradiation in the presence of recurrence after RT.
dc.identifier.doi10.1007/s00066-024-02338-z
dc.identifier.endpage437
dc.identifier.issn0179-7158
dc.identifier.issn1439-099X
dc.identifier.issue4
dc.identifier.pmid39692781
dc.identifier.scopusqualityQ1
dc.identifier.startpage431
dc.identifier.urihttps://doi.org/10.1007/s00066-024-02338-z
dc.identifier.urihttps://hdl.handle.net/20.500.12418/35640
dc.identifier.volume201
dc.identifier.wosWOS:001380022900001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer Heidelberg
dc.relation.ispartofStrahlentherapie Und Onkologie
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250504
dc.subjectHemangiopericytoma
dc.subjectSolitary fibrous tumor
dc.subjectIntracranial
dc.subjectRadiotherapy
dc.subjectAdjuvant
dc.titleThe role of radiotherapy in intracranial hemangiopericytoma/solitary fibrous tumors
dc.typeArticle

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