R L Haas1,2, I Walraven1, E Lecointe-Artzner3, W J van Houdt4, A N Scholten1, D Strauss5, Y Schrage4,5,6, A J Hayes5, C P Raut7, M Fairweather7, E H Baldini8,9,10, A Gronchi11, L De Rosa11, A M Griffin12, P C Ferguson12, J Wunder12, M A J van de Sande13, A D G Krol2, J Skoczylas14, D Brandsma15, F Doglietto16, C Sangalli17, S Stacchiotti18. 1. Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 2. Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands. 3. Sarcoma Patients EuroNet SPAEN, Bad Nauheim, Germany. 4. Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 5. Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK. 6. Department of Surgical Oncology, The Leiden University Medical Center, Leiden, The Netherlands. 7. Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. 8. Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA. 9. Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA. 10. Harvard Medical School, Boston, MA, USA. 11. Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 12. Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada. 13. Department of Orthopedic Oncology, The Leiden University Medical Center, Leiden, The Netherlands. 14. Department of Surgical Oncology, The Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland. 15. Department of Neuro-Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 16. Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. 17. Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 18. Adult Mesenchymal and Rare Tumor Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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.
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.
Entities:
Keywords:
Solitary fibrous tumor; central nervous system; hemangioperycitoma; radiotherapy; surgery