Management of recurrent meningeal hemangiopericytoma

• Published in: Cancer 1998-05, Vol.82 (10), p.1915-1920
• Main Authors: Galanis, Evanthia, Buckner, Jan C., Scheithauer, Bernd W., Kimmel, David W., Schomberg, Paula J., Piepgras, David G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; angioblastic meningioma; Antineoplastic Agents - therapeutic use; Biological and medical sciences; brain neoplasms; Combined Modality Therapy; Female; Follow-Up Studies; Hemangiopericytoma - drug therapy; Hemangiopericytoma - surgery; Hemangiopericytoma - therapy; Humans; Male; Medical sciences; meningeal hemangiopericytoma; Meningeal Neoplasms - drug therapy; Meningeal Neoplasms - surgery; Meningeal Neoplasms - therapy; Meninges; meningioma; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - surgery; Neoplasm Recurrence, Local - therapy; Neurology; Radiosurgery; Radiotherapy - methods; stereotactic radiosurgery; Survival Rate; Treatment Outcome; Tumors of the nervous system. Phacomatoses
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980515)82:10<1915::AID-CNCR15>3.0.CO;2-W

BACKGROUND Meningeal hemangiopericytoma is an uncommon neoplasm with a high propensity for recurrence. The purpose of this study was to analyze the efficacy of different treatment options in patients with recurrent disease. METHODS The records of all patients with recurrent meningeal hemangiopericytoma treated at the study institution between 1976 and 1996 were reviewed. RESULTS Thirty‐four consecutive patients were studied. The mainstay of treatment was brain surgery in 21 patients (62%); the median time to recurrence from surgery was 12 months. Ten patients (29%) had 20 recurrent central nervous system (CNS) lesions treated by stereotactic radiosurgery. Of these, 3 previously nonirradiated patients (all with lesion size < 25 mm) achieved a complete response, which persisted at a median of 3 years. In 14 lesions (70%) a partial response (PR) occurred with a median duration of 12 months, whereas 3 lesions (15%) remained stable. Two patients with inoperable CNS lesions received external beam radiation therapy and both had PRs lasting 14 and 24 months, respectively. Nine patients (26%) received radiation therapy for metastatic disease. Of these, seven patients remained stable with good symptomatic relief, and two patients experienced tumor progression. Chemotherapy with doxorubicin‐containing regimens was administered in 7 patients (21%); there was only 1 PR that lasted 8 months. The median survival from first recurrence was 4.6 years. CONCLUSIONS Surgical management is important for the successful treatment of patients with recurrent meningeal hemangiopericytoma. Radiosurgery plays a definite role in the treatment of smaller recurrent CNS lesions. Radiation therapy is helpful in the management of inoperable tumors. More effective chemotherapeutic agents are needed. Cancer 1998;82:1915‐20. © 1998 American Cancer Society. The majority of meningeal hemangiopericytomas recur in the central nervous system (CNS) (94%), whereas systemic metastases are observed in 56% of cases. The mainstay of treatment is surgery. Stereotactic radiosurgery has an important role in the treatment of smaller or medium sized CNS lesions.