title: Intracranial hemangiopericytoma: patterns of failure and the role of radiation therapy.
abstract: BACKGROUND
  Meningeal hemangiopericytoma (M-HPC) is a rare entity.
  
  
  OBJECTIVE
  To characterize our institutional experience in treating M-HPC.
  
  
  METHODS
  We reviewed the medical records of patients with M-HPC evaluated at The University of Texas M.D. Anderson Cancer Center between 1979 and 2009.
  
  
  RESULTS
  We identified 63 patients diagnosed between 1979 and 2009 with M-HPC treated with surgery alone or with postoperative radiotherapy (PORT). The majority were male (59%) and with a median age of 40.9 years (range, 0-71). Gross total resection (GTR) predominated (n = 31, 49%) followed by subtotal resection (n = 23, 37%) and unknown status (n = 9, 14.3%). PORT was delivered to 39 of the 63 patients (62%). The 5-, 10-, and 15-year overall survival were 90%, 68%, and 28%, respectively. The 5-, 10-, and 15-year local control (LC) were 70%, 37%, and 20%, respectively. The 5-, 10-, and 15-year metastasis-free survival were 85%, 39%, and 7%. PORT resulted in improved LC (hazard ratio [HR] 0.38, P = .008). Radiotherapy (RT) dose ≥60 Gy correlated with improved LC relative to <60 Gy (HR 0.12, P = .045). GTR correlated with improved LC (HR 0.40, P = .03). On multivariate analysis, PORT (HR 0.33, P = .003), GTR (HR = 0.33, P = .008), and RT dose ≥60 Gy (HR 0.33, P = .003) correlated with improved LC. Among those with GTR, PORT resulted in improved LC (HR 0.18, P = .027). Extent of resection and PORT did not correlate with improved overall survival.
  
  
  CONCLUSIONS
  In M-HPC, both PORT and GTR independently correlate with improved LC. PORT improves LC following GTR. We recommend RT dose ≥60 Gy to optimize LC.
authors.affiliation: *Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; ‡Department of Radiation Oncology, The University of Southern California, Los Angeles, California; §Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; ‖Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Amol J
authors.initials: AJ
authors.lastname: Ghia
authors.forename: Eric L
authors.initials: EL
authors.lastname: Chang
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Allen
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
authors.forename: Marta
authors.initials: M
authors.lastname: Penas-Prado
authors.forename: Ian E
authors.initials: IE
authors.lastname: McCutcheon
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006393:Hemangiopericytoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult