Elsevier

Radiotherapy and Oncology

Volume 144, March 2020, Pages 114-120
Radiotherapy and Oncology

Original Article
Radiotherapy in the treatment of extracranial hemangiopericytoma/solitary fibrous tumor: Study from the Rare Cancer Network

https://doi.org/10.1016/j.radonc.2019.11.011Get rights and content

Highlights

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    Radiotherapy improves LC and DFS in operated extremities/superficial trunk HPC/SFT.

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    Radiotherapy should be considered after resection of extracranial HPC/SFT.

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    Margin status could influence LC, DFS and MFS in extracranial HPC/SFT.

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    Maximum tumor diameter could influence OS, DFS and MFS in extracranial HPC/SFT.

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    Pathological grading could influence DFS in intra-thoracic/retroperitoneal HPC/SFT.

Abstract

Background and purpose

The role of radiotherapy (RT) in the treatment of hemangiopericytoma/solitary fibrous tumor (HPC/SFT) is still under debate. We aimed at investigating whether radiotherapy can improve the results in patients operated for extracranial HPC/SFT.

Materials and methods

Data from patients with HPC/SFT, treated from 1982 to 2012, were retrospectively reviewed within the Rare Cancer Network framework. Actuarial local control (LC), disease-free survival (DFS), metastasis-free survival (MFS) and overall survival (OS) were calculated with Kaplan-Meyer method. Patient and tumor parameters were analyzed by univariate and multivariate analysis.

Results

Of 114 HPC/SFT, 58 (50.9%) occurred in the extremities/superficial trunk and 56 (49.1%) in intra-thoracic/retroperitoneum. Seventy-eight patients (68.4%) underwent surgery only (Sx), and 36 (31.6%) Sx and RT (Sx + RT). Median RT dose was 60 Gy (range 45–68.4 Gy) in 1.6–2.2 Gy fractions. In the extremities/superficial trunk group of patients, actuarial 5-year LC rates were 50.4% after Sx and 91.6% after Sx + RT (p < 0.0001) for LC, and 50.4% after Sx and 83.1% after Sx + RT (p = 0.008) for DFS. In the intra-thoracic/retroperitoneum group of patients, actuarial 5-year rates were 89.3% after Sx and 77.8% after Sx + RT (p = 0.99) for LC, and 73.8% after Sx and 77.8% after Sx + RT (p = 0.93) for DFS. At multivariate analysis, the addition of RT resulted in better LC and DFS in the whole series. The advantage was confirmed for LC in the group of patients affected by extremity/superficial trunk tumors.

Conclusion

Addition of RT to Sx could improve the prognosis, in terms of LC and DFS, essentially in patients with extremities/superficial trunk tumor locations.

Section snippets

Materials and methods

Data of patients treated from January 1982 to December 2012 for extracranial HPC/SFT in Rare Cancer Network centers were collected anonymously after approval by the ethical committee following the rules of the institution of each participating center. Patients had to be >18 years with pathological diagnosis of HPC/SFT of any extracranial part of the body.

Results

Of 151 patients with extracranial HPC/SFT from 17 RCN centers and 10 countries over 20 years, 37 were excluded, leaving 114 patients available for the analysis: 13 cases were excluded for non-curative treatment mainly because of metastatic spread, 11 for unknown margin status after surgery, 9 for lack of follow-up and 4 for inhomogeneities of treatment modalities.

Main patient and treatment characteristics of the whole series (N = 114) and of the patients with extremities/superficial trunk (N

Discussion

In this series of extracranial HPC/SFT, all patients underwent surgery and about one third of them (31.6%) surgery + radiotherapy, providing the opportunity to study the role of adjuvant radiotherapy. Moreover, the presence of patients with various tumor locations allowed to analyze separately cases from extremities/superficial trunk and from intra-thoracic/retroperitoneum. Data collection over a long-time period allowed to assemble a large series with long follow-up of such rare disease.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the University Hospital “Maggiore della Carità”, Novara, Italy (Prot. 874/CE, Study N. CE 144/15). The study was performed in accordance with the Declaration of Helsinki.

Conflict of interest

No conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Acknowledgement

None.

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