Taro Murai1,2, Kengo Sato3,4, Michio Iwabuchi3, Yoshihiko Manabe5, Hiroyuki Ogino6, Hiromitsu Iwata6, Koshi Tatewaki4, Naoki Yokota7, Seiji Ohta6, Yuta Shibamoto5. 1. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan. taro8864@yahoo.co.jp. 2. Department of Radiology, Tsushima City Hospital, Tsushima, Japan. taro8864@yahoo.co.jp. 3. Department of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, Japan. 4. Yokohama CyberKnife Center, Yokohama, Japan. 5. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan. 6. Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Nagoya, Japan. 7. Radiation Oncology Center, Suzukake Central Hospital, Hamamatsu, Shizuoka, Japan.
Abstract
PURPOSE: Recurrent ependymomas were retreated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT). The efficacy, toxicities, and differences between SRS and FSRT were analyzed. METHODS: Eight patients with recurrent ependymomas fulfilling the criteria described below were evaluated. Inclusion criteria were: (1) the patient had previously undergone surgery and conventional radiotherapy as first-line treatment; (2) targets were located in or adjacent to the eloquent area or were deep-seated; and (3) the previously irradiated volume overlapped the target lesion. RESULTS: FSRT was delivered to 18 lesions, SRS to 20 lesions. A median follow-up period was 23 months. The local control rate was 76 % at 3 years. No significant differences in local control were observed due to tumor size or fractionation schedule. Lesions receiving >25 Gy/5 fr or 21 Gy/3 fr did not recur within 1 year, whereas no dose-response relationship was observed in those treated with SRS. No grade ≥2 toxicity was observed. CONCLUSION: Our treatment protocol provided an acceptable LC rate and minimal toxicities. Because local recurrence of tumors may result in patient death, a minimum dose of 21 Gy/3 fr or 25 Gy/5 fr or higher may be most suitable for treatment of these cases.
PURPOSE: Recurrent ependymomas were retreated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT). The efficacy, toxicities, and differences between SRS and FSRT were analyzed. METHODS: Eight patients with recurrent ependymomas fulfilling the criteria described below were evaluated. Inclusion criteria were: (1) the patient had previously undergone surgery and conventional radiotherapy as first-line treatment; (2) targets were located in or adjacent to the eloquent area or were deep-seated; and (3) the previously irradiated volume overlapped the target lesion. RESULTS: FSRT was delivered to 18 lesions, SRS to 20 lesions. A median follow-up period was 23 months. The local control rate was 76 % at 3 years. No significant differences in local control were observed due to tumor size or fractionation schedule. Lesions receiving >25 Gy/5 fr or 21 Gy/3 fr did not recur within 1 year, whereas no dose-response relationship was observed in those treated with SRS. No grade ≥2 toxicity was observed. CONCLUSION: Our treatment protocol provided an acceptable LC rate and minimal toxicities. Because local recurrence of tumors may result in patient death, a minimum dose of 21 Gy/3 fr or 25 Gy/5 fr or higher may be most suitable for treatment of these cases.
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Authors: Lucio De Maria; Lodovico Terzi di Bergamo; Alfredo Conti; Kazuhiko Hayashi; Valentina Pinzi; Taro Murai; Rachelle Lanciano; Sigita Burneikiene; Michela Buglione di Monale; Stefano Maria Magrini; Marco Maria Fontanella Journal: Front Oncol Date: 2021-03-29 Impact factor: 6.244