血管外皮细胞瘤是起源于齐默尔曼周细胞的罕见血管肿瘤。常规治疗包括全切除，然后进行辅助放疗。然而，它们浸润硬脑膜窦的倾向、高血管分布和解剖复杂性给根治性切除带来了挑战，导致复发的巨大风险。立体定向放射外科（SRS）已成为解决这些挑战的一种有前途的辅助疗法。我们的研究提供了最大规模的单机构回顾性研究，旨在评估 SRS 作为残留、复发和转移性血管外皮细胞瘤治疗方式的有效性和安全性。从 1998 年到 2023 年，斯坦福大学医学中心有 27 名患有 101 个肿瘤的患者接受了射波刀 SRS 治疗。治疗时的中位年龄为 51 岁。 SRS 的中位随访期为 103 个月（范围：6-250）。所有患者均接受了前期手术切除。中位肿瘤体积为1.5cc。中位单次等效剂量为 19 Gy。 SRS 在中位等剂量线的 76% 处进行（范围：64-89）。在 101 个接受治疗的肿瘤中，24 个（23.8%）出现进展，中位复发时间为 30 个月。 10 年时，局部肿瘤控制率 (LTC)、总生存率 (OS) 和无进展生存率 (PFS) 分别为 74.3%、80.8% 和 67%。在有转移性病灶的患者中，LTC 率明显高于有残留或复发肿瘤的患者。残留、复发和转移性血管外皮细胞瘤患者的 OS 和 PFS 没有显着差异。值得注意的是，没有检测到辐射引起的不良事件病例。SRS 带来了出色的 10 年 LTC、PFS 和 OS，不良事件风险可以忽略不计。因此，对于残留、复发和转移性血管外皮细胞瘤患者来说，它是一种有效且安全的治疗方式。版权所有 © 神经外科医生大会 2024。保留所有权利。

Hemangiopericytomas are infrequent vascular tumors originating from Zimmermann pericytes. The conventional treatment involves gross total resection, followed by adjuvant radiotherapy. Nevertheless, their tendency to infiltrate dural sinuses, high vascularity, and anatomic complexity pose challenges for radical resection, leading to a significant risk of recurrence. Stereotactic radiosurgery (SRS) has emerged as a promising adjuvant therapy to address these challenges. Our study provides the largest single-institutional retrospective, aiming to evaluate the effectiveness and safety of SRS as a treatment modality for residual, recurrent, and metastatic hemangiopericytomas.From 1998 to 2023, 27 patients with 101 tumors underwent CyberKnife SRS at Stanford University Medical Center. The median age was 51 years at the time of treatment. The median follow-up period from SRS was 103 months (range: 6-250). All patients underwent upfront surgical resection. The median tumor volume was 1.5 cc. The median single-fraction equivalent dose was 19 Gy. The SRS was administered at the 76% of the median isodose line (range: 64-89).Of the 101 treated tumors, 24 (23.8%) progressed with a median time to recurrence of 30 months. At 10 years, the rates of local tumor control (LTC), overall survival (OS), and progression-free survival (PFS) were 74.3%, 80.8%, and 67%, respectively. In patients with metastatic lesions, the LTC rates were significantly greater when compared with those with residual or recurrent tumors. There was no significant difference between patients with residual, recurrent, and metastatic hemangiopericytomas in OS and PFS. Notably, no cases of radiation-induced adverse events were detected.SRS leads to excellent LTC, PFS, and OS at 10 years with negligible risk for adverse events. Therefore, it is an effective and safe management modality for patients with residual, recurrent, and metastatic hemangiopericytomas.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.