MANAGEMENT OF RECURRENT MENINGEAL HEMANGIOPERICYTOMA

BACKGROUND. Meningeal hemangiopericytoma is an uncommon neoplasm with a high propensity for recurrence. The purpose of this study was to ana lyze the efficacy of different treatment options in patients with recu rrent disease. METHODS, The records of all patients with recurrent men ingeal hemangiopericytoma treated at the study institution between 197 6 and 1996 were reviewed. RESULTS. Thirty-four consecutive patients we re studied. The mainstay of treatment was brain surgery in 21 patients (62%); the median time to recurrence from surgery was 12 months. Ten patients (29%) had 20 recurrent central nervous system (CNS) lesions t reated by stereotactic radiosurgery. Of these, 3 previously nonirradia ted patients tall with lesion size < 25 mm) achieved a complete respon se, which persisted at a median of 3 years, In 14 lesions (70%) a part ial response (PR) occurred with a median duration of 12 months, wherea s 3 lesions (15%) remained stable. Two patients with inoperable CNS le sions received external beam radiation therapy and both had PRs lastin g 14 and 24 months, respectively. Nine patients (26%) received radiati on therapy for metastatic disease. Of these, seven patients remained s table with good symptomatic relief, and thio patients experienced tumo r progression. Chemotherapy with doxorubicin-containing regimens was a dministered in 7 patients (21%); there was only 1 PR that lasted 8 mon ths. The median survival from first recurrence was 4.6 years. CONCLUSI ONS. Surgical management is important for the successful treatment of patients with recurrent meningeal hemangiopericytoma. Radiosurgery pla ys a definite role in the treatment of smaller recurrent CNS lesions. Radiation therapy is helpful in the management of inoperable tumors. M ore effective chemotherapeutic agents are needed. (C) 1998 American Ca ncer Society.