Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy?

Authors

  • R. L. Haas Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
  • I. Walraven Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
  • E. Lecointe-Artzner Sarcoma Patients EuroNet SPAEN, Bad Nauheim, Germany
  • W. J. van Houdt Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
  • A. N. Scholten Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
  • D. Strauss Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
  • Y. Schrage Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK; Department of Surgical Oncology, The Leiden University Medical Center, Leiden, The Netherlands
  • A. J. Hayes Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
  • C. P. Raut Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
  • M. Fairweather Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
  • E. H. Baldini Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA; Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
  • A. Gronchi Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • L. De Rosa Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • A. M. Griffin Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
  • P. C. Ferguson Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
  • J. Wunder Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
  • M. A. J. van de Sande Department of Orthopedic Oncology, The Leiden University Medical Center, Leiden, The Netherlands
  • A. D. G. Krol Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
  • J. Skoczylas Department of Surgical Oncology, The Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland
  • D. Brandsma Department of Neuro-Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
  • F. Doglietto Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
  • C. Sangalli Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • S. Stacchiotti Adult Mesenchymal and Rare Tumor Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

DOI:

https://doi.org/10.1080/0284186X.2020.1826574

Keywords:

Solitary fibrous tumor, hemangioperycitoma, radio-therapy, surgery, central nervous system

Abstract

Introduction

A meningeal solitary fibrous tumor (SFT), also called hemangiopericytoma, is a rare mesenchymal malignancy. Due to anatomic constrains, even after macroscopic complete surgery with curative intent, the local relapse risk is still relatively high, thus increasing the risk of dedifferentiation and metastatic spread. This study aims to better define the role of postoperative radiotherapy (RT) in meningeal SFTs.

Patients and methods

A retrospective study was performed across seven sarcoma centers. Clinical information was retrieved from all adult patients with meningeal primary localized SFT treated between 1990 and 2018 with surgery alone (S) compared to those that also received postoperative RT (S + RT). Differences in treatment characteristics between subgroups were tested using independent samples t-test for continuous variables and chi-square tests for proportions. Local control (LC) and overall survival (OS) rates were calculated as time from start of treatment until progression or death from any cause. LC and OS in groups receiving S or S + RT were compared using Kaplan–Meier survival curves.

Results

Among a total of 48 patients, 7 (15%) underwent S and 41 (85%) underwent S + RT. Median FU was 65 months. LC was significantly associated with treatment. LC after S at 60 months was 60% versus 90% after S + RT (p = 0.052). Furthermore, R1 resection status was significantly associated with worse LC (HR 4.08, p = 0.038). OS was predominantly associated with the mitotic count (HR 3.10, p = 0.011).

Conclusion

This retrospective study, investigating postoperative RT in primary localized meningeal SFT patients, suggests that combining RT to surgery in the management of this patient population may reduce the risk for local failures.

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Published

2021-01-02

How to Cite

Haas, R. L., Walraven, I., Lecointe-Artzner, E., van Houdt, W. J., Scholten, A. N., Strauss, D., … Stacchiotti, S. (2021). Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy?. Acta Oncologica, 60(1), 35–41. https://doi.org/10.1080/0284186X.2020.1826574

Issue

Vol. 60 No. 1 (2021): Acta Oncologica

Section

Articles