PURPOSE: A retrospective study was performed to evaluate the long term efficacy and safety of post-operative radiation therapy in the management of spinal canal ependymoma at our institution. METHODS AND MATERIALS: Between 1954 and 1997, 22 patients with spinal canal ependymoma were treated with post-operative radiotherapy at our institution. The median age at diagnosis was 34.7 years (range 9.8-56.1 years). All patients underwent open biopsy with histologic diagnosis: 13 patients (59%) had ependymoma (WHO Grade II) and 9 patients (41%) had myxopapillary ependymoma (WHO Grade I). The median tumor size was 4.0 cm (range 1.5-15.0 cm). Twenty patients received subtotal resection and 2 patients received gross-total resection. Median radiation dose was 45.0 Gy. RESULTS: The median follow up for surviving patients was 11.4 years (range 0.6-37.0 years). An 80% progression-free-survival (PFS) was observed for all patients at 5-, 10- and 15-year endpoints. All recurrences were within 3 years of treatment. The 5-, 10- and 15-year overall-survivals (OS) for all patients were 85%, 78% and 64%, respectively. Patients with tumors larger than 6.0 cm at time of presentation demonstrated 5- and 10-year PFS of 58.3% compared to 92.3% for patients with tumors 6.0 cm or smaller (P = 0.047). There was no significant correlation between tumor size and OS. CONCLUSIONS: Post-operative radiation after subtotal resection is safe and offers durable tumor control and long term patient survival.
PURPOSE: A retrospective study was performed to evaluate the long term efficacy and safety of post-operative radiation therapy in the management of spinal canal ependymoma at our institution. METHODS AND MATERIALS: Between 1954 and 1997, 22 patients with spinal canal ependymoma were treated with post-operative radiotherapy at our institution. The median age at diagnosis was 34.7 years (range 9.8-56.1 years). All patients underwent open biopsy with histologic diagnosis: 13 patients (59%) had ependymoma (WHO Grade II) and 9 patients (41%) had myxopapillary ependymoma (WHO Grade I). The median tumor size was 4.0 cm (range 1.5-15.0 cm). Twenty patients received subtotal resection and 2 patients received gross-total resection. Median radiation dose was 45.0 Gy. RESULTS: The median follow up for surviving patients was 11.4 years (range 0.6-37.0 years). An 80% progression-free-survival (PFS) was observed for all patients at 5-, 10- and 15-year endpoints. All recurrences were within 3 years of treatment. The 5-, 10- and 15-year overall-survivals (OS) for all patients were 85%, 78% and 64%, respectively. Patients with tumors larger than 6.0 cm at time of presentation demonstrated 5- and 10-year PFS of 58.3% compared to 92.3% for patients with tumors 6.0 cm or smaller (P = 0.047). There was no significant correlation between tumor size and OS. CONCLUSIONS: Post-operative radiation after subtotal resection is safe and offers durable tumor control and long term patient survival.
Authors: Fadi Hanbali; Daryl R Fourney; Eric Marmor; Dima Suki; Laurence D Rhines; Jeffrey S Weinberg; Ian E McCutcheon; Ian Suk; Ziya L Gokaslan Journal: Neurosurgery Date: 2002-11 Impact factor: 4.654
Authors: J N Waldron; N J Laperriere; L Jaakkimainen; W J Simpson; D Payne; M Milosevic; C S Wong Journal: Int J Radiat Oncol Biol Phys Date: 1993-09-30 Impact factor: 7.038
Authors: Michael Safaee; Michael C Oh; Joseph M Kim; Derick Aranda; Phiroz E Tarapore; Tene A Cage; Nalin Gupta; Andrew T Parsa Journal: Childs Nerv Syst Date: 2013-05-16 Impact factor: 1.475
Authors: Michael C Oh; Michael E Ivan; Matthew Z Sun; Gurvinder Kaur; Michael Safaee; Joseph M Kim; Eli T Sayegh; Derick Aranda; Andrew T Parsa Journal: Neuro Oncol Date: 2012-12-09 Impact factor: 12.300
Authors: Eli T Sayegh; Derick Aranda; Joseph M Kim; Taemin Oh; Andrew T Parsa; Michael C Oh Journal: J Clin Neurosci Date: 2014-07-15 Impact factor: 1.961
Authors: Carlos A Bagley; Sean Wilson; Karl F Kothbauer; Markus J Bookland; Fred Epstein; George I Jallo Journal: Neurosurg Rev Date: 2009-02-17 Impact factor: 3.042
Authors: Michael C Oh; Phiroz E Tarapore; Joseph M Kim; Matthew Z Sun; Michael Safaee; Gurvinder Kaur; Derick M Aranda; Andrew T Parsa Journal: J Clin Neurosci Date: 2013-06-12 Impact factor: 1.961
Authors: Valerie N Barton; Andrew M Donson; Bette K Kleinschmidt-DeMasters; Diane K Birks; Michael H Handler; Nicholas K Foreman Journal: Brain Pathol Date: 2009-09-10 Impact factor: 6.508