Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
J Hematol Oncol. 2011 Jun 6;4:26. doi: 10.1186/1756-8722-4-26.
Hemangiopericytoma is a rare and aggressive meningeal tumor. Although surgical resection is the standard treatment, hemangiopericytomas often recur with high incidences of metastasis. The purpose of this study was to evaluate the role of CyberKnife stereotactic radiosurgery (CK) in the management of recurrent, metastatic, and residual hemangiopericytomas.
In a review of the Stanford radiosurgery database between 2002 and 2009, the authors found 14 patients who underwent CK therapy for recurrent, metastatic, and residual hemangiopericytomas. A total of 24 tumors were treated and the median patient age was 52 years (range 29-70 years) at the time of initial CK therapy. The median follow-up period was 37 months (10-73 months) and all patients had been previously treated with surgical resection. Mean tumor volume was 9.16 cm3 and the mean marginal and maximum radiosurgical doses to the tumors were 21.2 Gy and 26.8 Gy, respectively.
Of the 24 tumors treated, 22 have clinical follow-up data at this time. Of those 22 tumors, 12 decreased in size (54.5%), 6 remained unchanged (27.3%), and 4 showed recurrence (18.2%) after CK therapy. Progression-free survival rate was 95%, 71.5%, and 71.5% at 1, 3, and 5 years after multiple CK treatments. The 5-year survival rate after CK was 81%.
CK is an effective and safe management option for hemangiopericytomas. The current series demonstrates a tumor control of 81.8%. Other institutions have demonstrated similar outcomes with stereotactic radiosurgery, with tumor control ranging from 46.4% to 100%.
血管外皮细胞瘤是一种罕见且侵袭性的脑膜肿瘤。虽然手术切除是标准治疗方法，但血管外皮细胞瘤常复发且转移率较高。本研究旨在评估 CyberKnife 立体定向放射外科 (CK) 在复发性、转移性和残留血管外皮细胞瘤治疗中的作用。
在 2002 年至 2009 年期间对斯坦福放射外科数据库进行回顾性研究，作者发现 14 例患者因复发性、转移性和残留血管外皮细胞瘤接受 CK 治疗。共治疗 24 个肿瘤，初始 CK 治疗时患者中位年龄为 52 岁（范围 29-70 岁）。中位随访时间为 37 个月（10-73 个月），所有患者均接受过手术切除。肿瘤平均体积为 9.16cm³，肿瘤边缘和最大放射外科剂量的平均值分别为 21.2Gy 和 26.8Gy。
24 个肿瘤中，22 个有临床随访资料。在这 22 个肿瘤中，12 个肿瘤缩小（54.5%），6 个肿瘤保持不变（27.3%），4 个肿瘤在 CK 治疗后复发（18.2%）。多次 CK 治疗后 1、3 和 5 年的无进展生存率分别为 95%、71.5%和 71.5%。CK 治疗后 5 年生存率为 81%。
CK 是治疗血管外皮细胞瘤的有效且安全的治疗选择。本研究系列表明肿瘤控制率为 81.8%。其他机构使用立体定向放射外科治疗也取得了类似的结果，肿瘤控制率范围为 46.4%至 100%。
