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Postoperative Stereotactic Radiosurgery for Intracranial Solitary Fibrous Tumors/Hemangiopericytomas: A Systematic Review and Meta-Analysis Publisher



Hajikarimloo B1 ; Tos SM1 ; Mohammadzadeh I2 ; Habibi MA3
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Authors Affiliations
  1. 1. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, United States
  2. 2. Skull Base Research Center, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iraq
  3. 3. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iraq

Source: Journal of Clinical Neuroscience Published:2025


Abstract

Background: Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are infrequent neoplastic lesions characterized by hypercellularity and considerable vascularization. SFT/HPCs are associated with a considerably higher likelihood of recurrence and development of metastasis. Maximal safe resection with the goal of achieving gross total resection (GTR) is the gold-standard therapeutic option; however, it is challenging due to considerable vascularization and susceptibility to intraoperative hemorrhage concurrent with adjacency to the critical neurovascular structures. SRS has been demonstrated as an efficient adjuvant treatment option for intracranial SFT/HPCs. This meta-analysis evaluated the efficacy and safety of postoperative SRS in intracranial SFT/HPCs. Methods: On February 5, 2025, a comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted. Studies that evaluated SRS in intracranial SFT/HPCs and reported local tumor control (LTC), overall survival (OS), and progression-free survival (PFS) were included. The analysis was conducted in the R program. Results: Ten studies with 228 patients and 469 SFT/HPCs were included. The meta-analysis showed a pooled overall LTC rate of 68 % (95 %CI: 55 %–80 %), 1-year LTC rate of 94 % (95 %CI: 90 %–97 %), and 5-year LTC rate of 60 % (95 %CI: 42 %–76 %). The meta-analysis revealed a pooled overall OS rate of 59 % (95 %CI: 43 %–75 %), 5-year OS rate of 85 % (95 %CI: 67 %–97 %), and 10-year OS rate of 64 % (95 %CI: 25 %–95 %). In addition, The meta-analysis revealed a pooled ARE rate of 6 % (95 %CI: 3 %–9 %). Conclusion: Postoperative SRS is an efficient and safe adjuvant therapeutic option for intracranial SFT/HPCs. SRS has comparative results to conventional RT with lower ARE. Further prospective multicenter studies with large sample sizes are required to validate our findings. © 2025 Elsevier Ltd
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