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Pediatric intracranial ependymoma: The roles of surgery, radiation and chemotherapy
Journal of Neuro-Oncology, 08/16/2011
Clinical Article
Pejavar S et al. – The authors sought to investigate the roles of surgery, radiation, and chemotherapy in a historical cohort. The findings of this study suggest the benefit of RT even in the presence of GTR. Future prospective studies with larger sample number are needed to validate our findings.
Methods- 29 children, age 21 or younger, with non–metastatic intracranial ependymomas were treated from 1972 to 2008
- Median age was 8 years (range 0.2–19.1)
- 21 patients (54%) underwent GTRs, and 18 (45%) underwent STRs
- 26 patients (67%) received upfront adjuvant RT (67%), and 14 (44%) received adjuvant chemotherapy
- 24 patients had disease recurrence and 12 died
- 15 year PFS and OS were 30 and 67%
- Adjuvant RT was associated with improved PFS (P = 0.045), and remained significant after adjusting for EOR (P = 0.04)
- Greater EOR trended towards prolonged survival, but did not reach statistical significance (P = 0.156)
- Only 1 patient recurred after 5 years
- Median PFS 2.7 years and median OS 20 years
- Of the patients that underwent GTR, median PFS was 38 months for those treated with adjuvant RT versus 30 months for those that were not treated with RT
- Of patients that had STR, the median PFS for those treated with RT was 26.3 months versus 6.9 months for those were not treated with RT