BACKGROUND AND PURPOSE: To report disease control, survival and treatment-associated toxicity with the use of proton therapy (PRT) for re-irradiation of intracranial ependymoma. MATERIALS AND METHODS: Twenty patients underwent 33 PRT re-irradiation courses for recurrent or metastatic lesions between June 2004 and February 2015 at Massachusetts General Hospital. RESULTS: The majority of patients were female (60%), with infratentorial tumors (90%), anaplastic histology (55%), and initially received 55.8 GyRBE (52.2-59.4) involved field (IF) PRT. First failure was local (55%), distant (30%) or both (15%) at a median time of 23.9 months (9.9-98.5) from first treatment. Salvage therapy included re-resection (75%), chemotherapy (60%) and IFPRT (70%) to a median dose 50.4 GyRBE (35-55.8) in the majority of patients. The median follow-up was 37.8 months (5.5-138.0). Three year OS and PFS are 78.6% (95% CI 67.6-89.6) and 28.1% (95% CI 15.6-40.6), respectively. Longer OS was significantly associated with surgical resection of recurrent disease (HR 9.19, 95% CI 1.27-66.44, p=0.028). The pattern of second failure after re-irradiation was directly related to the pattern of first failure (p<0.01). Three of 14 patients (21.4%) locally re-treated experienced grade 2 radiation-associated treatment change. CONCLUSIONS: Proton therapy appears safe and efficacious for the re-treatment of recurrent intracranial ependymoma.
BACKGROUND AND PURPOSE: To report disease control, survival and treatment-associated toxicity with the use of proton therapy (PRT) for re-irradiation of intracranial ependymoma. MATERIALS AND METHODS: Twenty patients underwent 33 PRT re-irradiation courses for recurrent or metastatic lesions between June 2004 and February 2015 at Massachusetts General Hospital. RESULTS: The majority of patients were female (60%), with infratentorial tumors (90%), anaplastic histology (55%), and initially received 55.8 GyRBE (52.2-59.4) involved field (IF) PRT. First failure was local (55%), distant (30%) or both (15%) at a median time of 23.9 months (9.9-98.5) from first treatment. Salvage therapy included re-resection (75%), chemotherapy (60%) and IFPRT (70%) to a median dose 50.4 GyRBE (35-55.8) in the majority of patients. The median follow-up was 37.8 months (5.5-138.0). Three year OS and PFS are 78.6% (95% CI 67.6-89.6) and 28.1% (95% CI 15.6-40.6), respectively. Longer OS was significantly associated with surgical resection of recurrent disease (HR 9.19, 95% CI 1.27-66.44, p=0.028). The pattern of second failure after re-irradiation was directly related to the pattern of first failure (p<0.01). Three of 14 patients (21.4%) locally re-treated experienced grade 2 radiation-associated treatment change. CONCLUSIONS: Proton therapy appears safe and efficacious for the re-treatment of recurrent intracranial ependymoma.
Authors: P D Delgado-López; E M Corrales-García; E Alonso-García; R García-Leal; R González-Rodrigálvarez; E Araus-Galdós; J Martín-Alonso Journal: Clin Transl Oncol Date: 2019-03-13 Impact factor: 3.405
Authors: Derek S Tsang; Louise Murray; Vijay Ramaswamy; Michal Zapotocky; Uri Tabori; Ute Bartels; Annie Huang; Peter B Dirks; Michael D Taylor; Cynthia Hawkins; Eric Bouffet; Normand Laperriere Journal: Neuro Oncol Date: 2019-03-18 Impact factor: 12.300
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
Authors: Benjamin Farnia; Nancy Philip; Rola H Georges; Mary Frances McAleer; Matthew Palmer; Jinzhong Yang; Pamela K Allen; Mary K Martel; Anita Mahajan; Susan L McGovern Journal: Int J Part Ther Date: 2016-08-29