Hideyuki Kano1, Yan-Hua Su2, Hsiu-Mei Wu2, Gabriela Simonova3, Roman Liscak3, Or Cohen-Inbar4, Jason P Sheehan4, Antonio Meola5, Mayur Sharma5, Gene H Barnett5, David Mathieu6, Lucas T Vasas7, Anthony M Kaufmann7, Rachel C Jacobs1, L Dade Lunsford1. 1. Department of Neurological Surgery, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. Department of Neurosurgery, Taipei Veteran General Hospital, Taipei, Taiwan. 3. Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech. 4. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia. 5. Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio. 6. Division of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Canada. 7. Section of Neurosurgery, University of Manitoba, Canada.
Abstract
BACKGROUND: Stereotactic radiosurgery (SRS) is a potentially important option for intracranial ependymoma patients. OBJECTIVE: To analyze the outcomes of intracranial ependymoma patients who underwent SRS as a part of multimodality management. METHODS: Seven centers participating in the International Gamma Knife Research Foundation identified 89 intracranial ependymoma patients who underwent SRS (113 tumors). The median patient age was 16.3 yr (2.9-80). All patients underwent previous surgical resection and radiation therapy (RT) of their ependymomas and 40 underwent previous chemotherapy. Grade 2 ependymomas were present in 42 patients (52 tumors) and grade 3 ependymomas in 48 patients (61 tumors). The median tumor volume was 2.2 cc (0.03-36.8) and the median margin dose was 15 Gy (9-24). RESULTS: Forty-seven (53%) patients were alive and 42 (47%) patients died at the last follow-up. The overall survival after SRS was 86% at 1 yr, 50% at 3 yr, and 44% at 5 yr. Smaller total tumor volume was associated with longer overall survival (P = .006). Twenty-two patients (grade 2: n = 9, grade 3: n = 13) developed additional recurrent ependymomas in the craniospinal axis. The progression-free survival after SRS was 71% at 1 yr, 56% at 3 yr, and 48% at 5 yr. Adult age, female sex, and smaller tumor volume indicated significantly better progression-free survival. Symptomatic adverse radiation effects were seen in 7 patients (8%). CONCLUSION: SRS provides another management option for residual or recurrent progressive intracranial ependymoma patients who have failed initial surgery and RT.
BACKGROUND: Stereotactic radiosurgery (SRS) is a potentially important option for intracranial ependymomapatients. OBJECTIVE: To analyze the outcomes of intracranial ependymomapatients who underwent SRS as a part of multimodality management. METHODS: Seven centers participating in the International Gamma Knife Research Foundation identified 89 intracranial ependymomapatients who underwent SRS (113 tumors). The median patient age was 16.3 yr (2.9-80). All patients underwent previous surgical resection and radiation therapy (RT) of their ependymomas and 40 underwent previous chemotherapy. Grade 2 ependymomas were present in 42 patients (52 tumors) and grade 3 ependymomas in 48 patients (61 tumors). The median tumor volume was 2.2 cc (0.03-36.8) and the median margin dose was 15 Gy (9-24). RESULTS: Forty-seven (53%) patients were alive and 42 (47%) patients died at the last follow-up. The overall survival after SRS was 86% at 1 yr, 50% at 3 yr, and 44% at 5 yr. Smaller total tumor volume was associated with longer overall survival (P = .006). Twenty-two patients (grade 2: n = 9, grade 3: n = 13) developed additional recurrent ependymomas in the craniospinal axis. The progression-free survival after SRS was 71% at 1 yr, 56% at 3 yr, and 48% at 5 yr. Adult age, female sex, and smaller tumor volume indicated significantly better progression-free survival. Symptomatic adverse radiation effects were seen in 7 patients (8%). CONCLUSION:SRS provides another management option for residual or recurrent progressive intracranial ependymomapatients who have failed initial surgery and RT.
Authors: Felix Ehret; Markus Kufeld; Christoph Fürweger; Alfred Haidenberger; Paul Windisch; Carolin Senger; Melina Kord; Malte Träger; David Kaul; Christian Schichor; Jörg-Christian Tonn; Alexander Muacevic Journal: Front Oncol Date: 2021-04-29 Impact factor: 6.244