Meningeal hemangiopericytoma: A retrospective study of 21 patients with special review of postoperative external radiotherapy

OBJECTIVE: To specify that postoperative radiotherapy is useful for prevent ing local recurrence and neuraxis recurrence of surgically treated meningea l hemangiopericytomas. METHODS: We retrospectively studied 21 patients with meningeal hemangioperi cytoma who were followed in our department during a 34-year period. In 17 p atients, the meningeal hemangiopericytoma was intracranial, and in 4 there was an intradural extramedullary localization. These groups were studied se parately. RESULTS: Of the 17 patients with intracranial hemangiopericytoma, all under went surgery; 8 also underwent radiotherapy (5000-6400 rads) (Group I), and 9 did not (Group II). The mortality rate was zero for Group patients and 5 5% for Group II. The mean local recurrence rate was 52% (12.5% in Group I a nd 88% in Group II; P < 0.05). Neuraxis recurrences occurred in two patient s in Group II, and none occurred in Group I (P = 0.4). Peripheral metastasi s took place in two patients (22%) in Group II and in one patient (12.5%) i n Group I (P = 0.5). Of the four patients with intradural extramedullary he mangiopericytoma, all underwent surgery. Two patients received 4000 rads of radiotherapy after intervention. No patient in this group had a recurrence . CONCLUSION: For patients with intracranial meningeal hemangiopericytoma, su rgical removal followed by external radiotherapy reduced the risk of local recurrence. It was not demonstrated that postoperative radiotherapy protect ed against neuraxis metastasis. Radiotherapy did not protect against periph eral metastasis, which can occur up to several years after the first operat ion. It appears that radiotherapy after surgery for local or neuraxis recur rence did not avoid further recurrence. Radiosurgery is indicated for recur rent tumors measuring less than 25 mm in greatest diameter. For intradural extramedullary localizations, the value of postoperative radiotherapy is mo re questionable.