BACKGROUND AND PURPOSE: To evaluate the outcome of very young children with anaplastic ependymoma after delayed or omitted radiotherapy (RT). MATERIALS AND METHODS: Children under age of 3 years with anaplastic ependymoma were enrolled in the HIT-SKK 87 trial from 1987. After surgery, low-risk patients (R0, M0) received maintenance chemotherapy until elective RT at age of three. In high-risk patients (R+, M+) intensive induction chemotherapy was followed by maintenance chemotherapy and subsequently delayed RT. If there was, progression radiotherapy started immediately. In the HIT-SKK 92, trial MTX-based chemotherapy was applied. RT was administered in non-responders only. RESULTS: Thirty-four children with anaplastic ependymoma were eligible (age 1.0-33.0 months). All children received chemotherapy. In 13 children, no RT was administered. Preventive RT after chemotherapy was given in nine, and salvage RT in 12 children. OS and PFS rates after 3-year were 55.9 and 27.3%, respectively. Twenty-five children relapsed. Positive impact on survival was observed in children with higher age, M0-stage, complete resection, and treatment with radiotherapy. Without RT only 3/13, children survived. CONCLUSION: Delaying RT jeopardizes survival even after intensive chemotherapy. Predominant site of failure is the primary tumor site. RT of the neuraxis should be omitted in localized disease.
BACKGROUND AND PURPOSE: To evaluate the outcome of very young children with anaplastic ependymoma after delayed or omitted radiotherapy (RT). MATERIALS AND METHODS:Children under age of 3 years with anaplastic ependymoma were enrolled in the HIT-SKK 87 trial from 1987. After surgery, low-risk patients (R0, M0) received maintenance chemotherapy until elective RT at age of three. In high-risk patients (R+, M+) intensive induction chemotherapy was followed by maintenance chemotherapy and subsequently delayed RT. If there was, progression radiotherapy started immediately. In the HIT-SKK 92, trial MTX-based chemotherapy was applied. RT was administered in non-responders only. RESULTS: Thirty-four children with anaplastic ependymoma were eligible (age 1.0-33.0 months). All children received chemotherapy. In 13 children, no RT was administered. Preventive RT after chemotherapy was given in nine, and salvage RT in 12 children. OS and PFS rates after 3-year were 55.9 and 27.3%, respectively. Twenty-five children relapsed. Positive impact on survival was observed in children with higher age, M0-stage, complete resection, and treatment with radiotherapy. Without RT only 3/13, children survived. CONCLUSION: Delaying RT jeopardizes survival even after intensive chemotherapy. Predominant site of failure is the primary tumor site. RT of the neuraxis should be omitted in localized disease.
Authors: Bernward G Hinkes; Katja von Hoff; Frank Deinlein; Monika Warmuth-Metz; Niels Soerensen; Beate Timmermann; Uwe Mittler; Christian Urban; Udo Bode; Torsten Pietsch; Paul G Schlegel; Rolf D Kortmann; Joachim Kuehl; Stefan Rutkowski Journal: J Neurooncol Date: 2006-08-29 Impact factor: 4.130
Authors: Martin Benesch; Martin Mynarek; Hendrik Witt; Monika Warmuth-Metz; Torsten Pietsch; Brigitte Bison; Stefan M Pfister; Kristian W Pajtler; Marcel Kool; Ulrich Schüller; Klaus Pietschmann; Björn-Ole Juhnke; Stephan Tippelt; Gudrun Fleischhack; Irene Schmid; Christof M Kramm; Peter Vorwerk; Andreas Beilken; Carl Friedrich Classen; Pablo Hernáiz Driever; Gabriele Kropshofer; Thomas Imschweiler; Andreas Lemmer; Rolf-Dieter Kortmann; Stefan Rutkowski; Katja von Hoff Journal: Oncologist Date: 2019-03-08
Authors: Carmen Ares; Francesca Albertini; Martina Frei-Welte; Alessandra Bolsi; Michael A Grotzer; Gudrun Goitein; Damien C Weber Journal: J Neurooncol Date: 2016-03-05 Impact factor: 4.130