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Abstract
Purpose: This study aimed to evaluate the role of postoperative radiotherapy (PORT) in intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).

Materials and methods: A total of 133 patients with histologically confirmed HPC were included from eight institutions. Gross total resection (GTR) and subtotal resection (STR) were performed in 86 and 47 patients, respectively. PORT was performed in 85 patients (64%). The prognostic effects of sex, age, performance, World Health Organization (WHO) grade, location, size, Ki-67, surgical extent, and PORT on local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were estimated by univariate and multivariate analyses.

Results: The 10-year PFS, and OS rates were 45%, and 71%, respectively. The multivariate analysis suggested that PORT significantly improved LC (p < 0.001) and PFS (p < 0.001). The PFS benefit of PORT was maintained in the subgroup of GTR (p=0.001), WHO grade II (p=0.001), or STR (p < 0.001). In the favorable subgroup of GTR and WHO grade II, PORT was also significantly related to better PFS (p=0.028). WHO grade III was significantly associated with poor DMFS (p=0.029). In the PORT subgroup, the 0-0.5 cm margin of the target volume showed an inferior LC to a large margin with 1.0-2.0 cm (p=0.021). Time-dependent Cox proportion analysis showed that distant failures were significantly associated with poor OS (p=0.003).

Conclusion: This multicenter study supports the role of PORT in disease control of intracranial SFT/HPC, irrespective of the surgical extent and grade. For LC, PORT should enclose the tumor bed with sufficient margin.

Affiliations

Joo Ho Lee  1   2 , Seung Hyuck Jeon  1 , Chul-Kee Park  3 , Sung-Hye Park  4 , Hong In Yoon  5 , Jong Hee Chang  6 , Chang-Ok Suh  5   7 , Su Jeong Kang  8 , Do Hoon Lim  8 , In Ah Kim  9 , Jin Hee Kim  10 , Jung Ho Im  7 , Sung-Hwan Kim  11 , Chan Woo Wee  12 , Il Han Kim  1
1 Department of Radiation Oncology, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, Korea.
2 Institute of Radiation Medicine, Medical Research Center, Seoul National University Hospital, Seoul, Korea.
3 Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
4 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
5 Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea.
6 Department of Neurosurgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
7 Department of Radiation Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
8 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
9 Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
10 Department of Radiation Oncology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
11 Department of Radiation Oncology, St. Vincent's Hospital, Suwon, Korea.
12 Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Korea.