Patterns of care and outcomes of postoperative radiation for intracranial hemangiopericytoma in United States hospitals

Objective: Several small ( < 100 patients) studies have been suggestive of a survival benefit associated with postoperative radiation for intracranial hemangiopericytoma. Given the rarity of this disease, we sought to examine the patterns of care and outcomes of this tumor in the National Cancer Database (NCDB). Patients and Methods: We accessed the NCDB to identify patients with intracranial hemangiopericytoma between 2004-2012. Patients were categorized by surgical status, postoperative radiation usage, and location (meningeal or brain parenchyma). Multivariable Cox regression was used to identify covariables associated with differences in survival. Results: There were 588 patients included in this study, of which 323 (54.9%) received postoperative radiation. The median age at diagnosis was 51 years and the median follow up was 55.1 months. There were no differences in overall survival between the two groups. The 5-year overall survival was 77.1% for those receiving postoperative radiation and 83.8% for those who did not (p = .14). On subgroup analysis by tumor location there remained no significant differences between groups. For those with tumors in the brain parenchyma, the 5-year overall survival was 77.6% for postoperative radiation compared to 85.8% for no postoperative radiation (p = .08). For those with tumors identified as being meningeal in origin, the 5-year overall survival was 75.7% for those who received postoperative radiation compared to 81.6% for those who did not receive postoperative radiation (p = .86). On multivariable analysis, postoperative radiation was not associated with any differences on survival (HR 1.35. 95% CI 0.90-2.02, p = .15). Conclusions: More than 50% of patients with hemangiopericytoma received postoperative radiation but there was no survival benefit associated with this treatment. This is a hypothesis-generating study and further studies are necessary to better determine how best to treat this rare disease.