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13.11.2023 | Review

Postoperative stereotactic radiosurgery for intracranial solitary fibrous tumors: systematic review and pooled quantitative analysis

verfasst von: Danielle Golub, Joshua D. McBriar, Hayley Donaldson, Taylor Wong, Prashin Unadkat, Timothy G. White, Eric T. Quach, Sara Haddock, Bhargava Chitti, Yonah Ziemba, Anuj Goenka, Samuel Singer, Michael Schulder, Amir R. Dehdashti

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2023

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Abstract

Background

Intracranial solitary fibrous tumors (SFTs), formerly hemangiopericytomas (HPCs), are rare, aggressive dural-based mesenchymal tumors. While adjuvant radiation therapy has been suggested to improve local tumor control (LTC), especially after subtotal resection, the role of postoperative stereotactic radiosurgery (SRS) and the optimal SRS dosing strategy remain poorly defined.

Methods

PubMed, EMBASE, and Web of Science were systematically searched according to PRISMA guidelines for studies describing postoperative SRS for intracranial SFTs. The search strategy was defined in the authors’ PROSPERO protocol (CRD42023454258).

Results

15 studies were included describing 293 patients harboring 476 intracranial residual or recurrent SFTs treated with postoperative SRS. At a mean follow-up of 21–77 months, LTC rate after SRS was 46.4–93% with a mean margin SRS dose of 13.5–21.7 Gy, mean maximum dose of 27-39.6 Gy, and mean isodose at the 42.5–77% line. In pooled analysis of individual tumor outcomes, 18.7% of SFTs demonstrated a complete SRS response, 31.7% had a partial response, 18.9% remained stable (overall LTC rate of 69.3%), and 30.7% progressed. When studies were stratified by margin dose, a mean margin dose > 15 Gy showed an improvement in LTC rate (74.7% versus 65.7%).

Conclusions

SRS is a safe and effective treatment for intracranial SFTs. In the setting of measurable disease, our pooled data suggests a potential dose response of improving LTC with increasing SRS margin dose. Our improved understanding of the aggressive biology of SFTs and the tolerated adjuvant SRS parameters supports potentially earlier use of SRS in the postoperative treatment paradigm for intracranial SFTs.

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Titel: Postoperative stereotactic radiosurgery for intracranial solitary fibrous tumors: systematic review and pooled quantitative analysis
verfasst von: Danielle Golub
Joshua D. McBriar
Hayley Donaldson
Taylor Wong
Prashin Unadkat
Timothy G. White
Eric T. Quach
Sara Haddock
Bhargava Chitti
Yonah Ziemba
Anuj Goenka
Samuel Singer
Michael Schulder
Amir R. Dehdashti
Publikationsdatum: 13.11.2023
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2023
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04499-w

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