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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.142    [Accepted]
The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-Institutional Retrospective Study (KROG 18-11)
Joo Ho Lee1,2, Seung Hyuck Jeon1, Chul-Kee Park3, Sung-Hye Park4, Hong In Yoon5, Jong Hee Chang6, Chang-Ok Suh5,10, Su Jeong Kang7, Do Hoon Lim7, In Ah Kim8, Jin Hee Kim9, Jung Ho Im10, Sung-Hwan Kim11, Chan Woo Wee12, Il Han Kim1
1Department of Radiation Oncology, Seoul National University Hospital, Seoul National University, College of Medicine, Seoul, Korea
2Institute of Radiation Medicine, Medical Research Center, Seoul National University Hospital, Seoul, Korea
3Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
4Department of Pathology, Seoul National University, College of Medicine, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
5Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
6Department of Neurosurgery, Severance Hospital, Yonsei University Health System, Seoul, Korea
7Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
8Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
9Department of Radiation Oncology, Keimyung University Dongsan Hospital, School of Medicine, Daegu, Korea
10Department of Radiation Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
11Department of Radiation Oncology, St. Vincent’s Hospital, Suwon, Korea
12Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Korea
Correspondence  Il Han Kim ,Tel: 82-2-2702-2819, Fax: 82-2-765-3317, Email: ihkim@snu.ac.kr
Received: January 28, 2021;  Accepted: March 23, 2021.  Published online: March 24, 2021.
To evaluate the role of postoperative radiotherapy (PORT) in intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).
and Materials A total of 133 patients with histologically confirmed HPC were included from 8 institutions. Gross total resection (GTR) and subtotal resection (STR) were performed in 86 and 47 patients, respectively. PORT was performed in 85 (64%) patients. The prognostic effects of sex, age, performance, 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.
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).
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.
Key words: Hemangiopericytoma, Solitary fibrous tumor, Intracranial, Radiotherapy, Margin, Postoperative
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