Department of Radiation Oncology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Department of Pathology, Seoul National University Hospital, Seoul, South Korea.
J Neurooncol. 2018 May;137(3):567-573. doi: 10.1007/s11060-018-2746-3. Epub 2018 Jan 11.
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40). The median follow-up period was 50 months (range 3-216 months). The local recurrence was defined as intracranial relapse within 15 mm and regional recurrence as beyond 15 mm from the margin of surgical bed. The 10-year overall survival (OS) and progression-free survival (PFS) were 69.9 and 34.4%, respectively. The 10-year local, regional, and distant failure-free rates were 56.6, 88.2, and 73.3%, respectively. Local tumor control was better with GTR followed by RT than GTR alone (p = 0.056), while there was no difference in OS. Local tumor control and OS after STR plus RT were equivalent to those after GTR alone. There were no differences in distant metastasis-free survival (DMFS) among GTR plus RT, GTR alone, and STR plus RT. Tumor volume > 40 cm was associated with poor PFS (p = 0.024). The local tumor recurrence was reduced by adjuvant RT after surgery. But OS or DMFS was not improved with adjuvant RT. PFS was better in the tumor with small volume at diagnosis.
我们回顾性评估了颅内血管外皮细胞瘤（HPC）辅助放疗（RT）的疗效，并分析了影响治疗结果的预后因素。在 1995 年至 2016 年间诊断为局限性颅内 HPC 的 49 例患者中，31 例患者在手术后接受了辅助 RT；26 例采用分割放疗，5 例采用伽玛刀立体定向放疗。在完全切除（GTR）（n=32）和次全切除（STR）（n=17）后，组织病理学分级确认为 2 级（n=9）或 3 级（n=40）。中位随访时间为 50 个月（范围 3-216 个月）。局部复发定义为颅内复发距离手术床边缘 15mm 以内，区域复发定义为超过 15mm。10 年总生存率（OS）和无进展生存率（PFS）分别为 69.9%和 34.4%。10 年局部、区域和远处无失败生存率分别为 56.6%、88.2%和 73.3%。GTR 后加 RT 比 GTR 单独治疗的局部肿瘤控制更好（p=0.056），但 OS 无差异。STR 后加 RT 的局部肿瘤控制和 OS 与 GTR 单独治疗相当。GTR 后加 RT、GTR 单独治疗和 STR 后加 RT 的远处无转移生存率（DMFS）无差异。肿瘤体积>40cm 与较差的 PFS 相关（p=0.024）。手术后辅助 RT 可减少局部肿瘤复发。但 OS 或 DMFS 未因辅助 RT 而改善。诊断时肿瘤体积较小的患者 PFS 更好。
