PURPOSE: To prospectively investigate the role of local hyperfractionated radiotherapy (RT) after surgical resection in the treatment of intracranial ependymomas in children. PATIENTS AND METHODS: Postoperative local hyperfractionated RT was proposed for every child (>5 years old at diagnosis) with localized intracranial ependymoma. The planned dose was 60 Gy after complete resection (CR) and 66 Gy after partial resection, delivered in two daily fractions of 1 Gy, according to the early postoperative imaging findings. RESULTS: Between November 1996 and December 2002, 24 children with infratentorial (n = 20) or supratentorial (n = 4) intracranial ependymoma were included. The median age was 8.6 years (range, 5-17). The World Health Organization grade was anaplastic in 10 of the 24 patients (not assessable in 1). After a retrospective central review, a CR was reported in 16 patients, partial resection in 4, and doubtful resection in 4. The radiation dose was 60 Gy in 18 cases (one partial resection), 66 Gy in 5 cases (one CR), and 54 Gy in 1 case (CR). The 5-year overall survival rate was 74.8%, and the progression-free survival rate was 54.2%. Of the 24 patients, 11 developed a relapse: 7 local only and 4 metastatic and local. The histological grade and extent of resection were not prognostic factors. More than 3 in 4 children had no sequelae of RT at a median follow-up of 7 years (95% confidence interval, 66.4-90.0 months). CONCLUSION: The results of our study have shown that hyperfractionated RT is safe but provides no outcome benefit compared with other strategies of RT such as standard fractionated regimens.
PURPOSE: To prospectively investigate the role of local hyperfractionated radiotherapy (RT) after surgical resection in the treatment of intracranial ependymomas in children. PATIENTS AND METHODS: Postoperative local hyperfractionated RT was proposed for every child (>5 years old at diagnosis) with localized intracranial ependymoma. The planned dose was 60 Gy after complete resection (CR) and 66 Gy after partial resection, delivered in two daily fractions of 1 Gy, according to the early postoperative imaging findings. RESULTS: Between November 1996 and December 2002, 24 children with infratentorial (n = 20) or supratentorial (n = 4) intracranial ependymoma were included. The median age was 8.6 years (range, 5-17). The World Health Organization grade was anaplastic in 10 of the 24 patients (not assessable in 1). After a retrospective central review, a CR was reported in 16 patients, partial resection in 4, and doubtful resection in 4. The radiation dose was 60 Gy in 18 cases (one partial resection), 66 Gy in 5 cases (one CR), and 54 Gy in 1 case (CR). The 5-year overall survival rate was 74.8%, and the progression-free survival rate was 54.2%. Of the 24 patients, 11 developed a relapse: 7 local only and 4 metastatic and local. The histological grade and extent of resection were not prognostic factors. More than 3 in 4 children had no sequelae of RT at a median follow-up of 7 years (95% confidence interval, 66.4-90.0 months). CONCLUSION: The results of our study have shown that hyperfractionated RT is safe but provides no outcome benefit compared with other strategies of RT such as standard fractionated regimens.
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: 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: C A Taschner; O Staszewski; V van Velthoven; M Müller; U Kontny; C Hader; M Prinz Journal: Clin Neuroradiol Date: 2011-06 Impact factor: 3.649
Authors: Roberta Rudà; Guido Reifenberger; Didier Frappaz; Stefan M Pfister; Anne Laprie; Thomas Santarius; Patrick Roth; Joerg Christian Tonn; Riccardo Soffietti; Michael Weller; Elizabeth Cohen-Jonathan Moyal Journal: Neuro Oncol Date: 2018-03-27 Impact factor: 12.300