Chen Li-feng, Yang Yang, Yu Xin-guang, Gui Qiu-ping, Xu Bai-nan, Zhou Ding-biao
Department of Neurosurgery, The Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
Department of Geriatric Neurology, The Chinese PLA General Hospital, Haidian District, Beijing, China.
J Clin Neurosci. 2015 Apr;22(4):718-25. doi: 10.1016/j.jocn.2014.11.011. Epub 2015 Mar 3.
Intracranial hemangiopericytoma (HPC) is a rare malignant meningothelial tumor. The authors retrospectively reviewed the long-term clinical outcomes of patients with HPC with regard to treatment modalities and histopathological grades. Eighteen women and 20 men (mean age 38.5 years, range, 18-62 years) were observed over an average follow-up period of 61 months (range, 15-133 months) between 2003 and 2013. The initial treatment modalities included total tumor resection followed by conventional radiotherapy (RT) (n=27), and subtotal tumor resection followed by stereotactic radiosurgery (n=11). One patient (3%) had permanent neurological deficits, and six patients (16%) died. Thirteen patients (34%) suffered recurrence. One year, 5 year, and 10 year recurrence-free survival rates were 100%, 70%, and 39%, respectively. Five patients (13%) developed metastasis. One year, 5 year, and 10 year metastasis-free survival rates were 100%, 89%, 74%, respectively. Low grade tumors were associated with longer overall survival, recurrence-free interval and metastasis-free interval (log-rank, p<0.05). Radical resection with RT was associated with longer overall survival and recurrence-free interval (log-rank, p<0.05), but had no effect on the metastasis-free interval (log-rank, p=0.245). Thus, radical surgery followed by adjuvant RT is the primary treatment of HPC, but recurrence and metastasis remain a common treatment outcome regardless of initial strategy. It is necessary to maintain long-term follow-up and serial imaging for all patients with intracranial HPC after treatment, regardless of extent of resection.
颅内血管外皮细胞瘤（HPC）是一种罕见的恶性脑膜上皮肿瘤。作者回顾性分析了HPC患者在治疗方式和组织病理学分级方面的长期临床结果。在2003年至2013年期间，共观察了18名女性和20名男性（平均年龄38.5岁，范围为18 - 62岁），平均随访期为61个月（范围为15 - 133个月）。初始治疗方式包括全肿瘤切除后进行常规放疗（RT）（n = 27），以及次全肿瘤切除后进行立体定向放射外科治疗（n = 11）。1例患者（3%）出现永久性神经功能缺损，6例患者（16%）死亡。13例患者（34%）复发。1年、5年和10年无复发生存率分别为100%、70%和39%。5例患者（13%）发生转移。1年、5年和10年无转移生存率分别为100%、89%、74%。低级别肿瘤与更长的总生存期、无复发间期和无转移间期相关（对数秩检验，p < 0.05）。根治性切除联合放疗与更长的总生存期和无复发间期相关（对数秩检验，p < 0.05），但对无转移间期无影响（对数秩检验，p = 0.245）。因此，根治性手术联合辅助放疗是HPC的主要治疗方法，但无论初始治疗策略如何，复发和转移仍然是常见的治疗结局。对于所有颅内HPC患者，无论切除范围如何，治疗后都有必要进行长期随访和系列影像学检查。
