Anne Ducassou1, Laetitia Padovani2, Leonor Chaltiel3, Stéphanie Bolle4, Jean-Louis Habrand5, Line Claude6, Christian Carrie6, Xavier Muracciole2, Bernard Coche-Dequeant7, Claire Alapetite8, Stéphane Supiot9, Charlotte Demoor-Goldschmidt9, Valerie Bernier-Chastagner10, Aymeri Huchet11, Julie Leseur12, Elisabeth Le Prise12, Christine Kerr13, Gilles Truc14, Tan Dat Nguyen15, Anne-Isabelle Bertozzi16, Didier Frappaz17, Sergio Boetto18, Annick Sevely19, Fatima Tensaouti20, Anne Laprie21. 1. Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du, Cancer de Toulouse, Oncopole, Toulouse, France. 2. Department of Radiation Oncology, CHU La Timone, Marseille, France. 3. Statistics Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Oncopole, Toulouse, France. 4. Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France. 5. Department of Radiation Oncology, Centre François Baclesse, Caen, France. 6. Department of Radiation Oncology, Centre Léon Bérard, Lyon, France. 7. Department of Radiation Oncology, Centre Oscar Lambret, Lille, France. 8. Department of Radiation Oncology, Institut Curie, Paris, France. 9. Department of Radiation Oncology, Centre René Gauducheau, Nantes, France. 10. Department of Radiation Oncology, Centre Alexis Vautrin, Nancy, France. 11. Department of Radiation Oncology, Centre Hospitalier et Universitaire, Bordeaux, France. 12. Department of Radiation Oncology, Centre Eugène Marquis, Rennes, France. 13. Department of Radiation Oncology, Institut du Cancer de Montpellier - Val d'Aurelle, Montpellier, France. 14. Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France. 15. Department of Radiation Oncology, Institut Jean Godinot, Reims, France. 16. Department of Pediatric Onco-hematology, CHU Toulouse, France. 17. Department of Pediatric Onco-hematology, IHOP, Lyon, France. 18. Department of Neurosurgery, CHU Toulouse, Toulouse, France. 19. Department of Pediatric Neuro-radiology, CHU Toulouse, Toulouse, France. 20. Toulouse NeuroImaging Center, ToNIC, Université de Toulouse, Inserm, UPS, Toulouse, France. 21. Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du, Cancer de Toulouse, Oncopole, Toulouse, France; Toulouse NeuroImaging Center, ToNIC, Université de Toulouse, Inserm, UPS, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France. Electronic address: laprie.anne@iuct-oncopole.fr.
Abstract
PURPOSE: The objective of this study was to analyze survival and prognostic factors for children, adolescents, and young adults treated with postoperative radiation therapy (RT) for intracranial ependymoma. METHODS AND MATERIALS: Between 2000 and 2013, 202 patients aged ≤25 years were treated in the 13 main French pediatric RT reference centers. Their medical records were reviewed for information, treatments received, and survival rates. All children had received postoperative RT- conformal, intensity modulated, or proton beam. In 2009, the prescribed standard dose in France rose from 54 Gy to 59.4 Gy. RESULTS: Median follow-up was 53.8 months (95% confidence interval [CI] 47-63.5). Median age at RT was 5 years (range 1-22), and 32% of the children treated were aged <3 years. Regarding treatment, 85.6% of patients underwent gross total resection, 62% of patients received conformal RT (vs 29% for intensity modulated RT and 8% for proton beam RT), 62.4% of patients received a dose >54 Gy, and 71% received chemotherapy. Of the 84 relapses, 75% were local. The cumulative incidence of local relapse was 24.4% (95% CI 18.2-31.2) at 3 years and 31.3% (95% CI 24-38.9) at 5 years. The 5-year disease-free survival (DFS) and overall survival rates were 50.4% (95% CI 42.2-58) and 71.4% (95% CI 63.1-78.2). Tumor grade was the only prognostic factor for local relapse and DFS. Tumor grade, age, and extent of resection were independent prognostic factors for overall survival. CONCLUSIONS: We confirmed several clinical and tumoral prognostic factors in a large French multicenter study. DFS for intracranial ependymoma remains low, and new biological and imaging markers are needed to distinguish among different subtypes, adapt treatments, and improve survival.
PURPOSE: The objective of this study was to analyze survival and prognostic factors for children, adolescents, and young adults treated with postoperative radiation therapy (RT) for intracranial ependymoma. METHODS AND MATERIALS: Between 2000 and 2013, 202 patients aged ≤25 years were treated in the 13 main French pediatric RT reference centers. Their medical records were reviewed for information, treatments received, and survival rates. All children had received postoperative RT- conformal, intensity modulated, or proton beam. In 2009, the prescribed standard dose in France rose from 54 Gy to 59.4 Gy. RESULTS: Median follow-up was 53.8 months (95% confidence interval [CI] 47-63.5). Median age at RT was 5 years (range 1-22), and 32% of the children treated were aged <3 years. Regarding treatment, 85.6% of patients underwent gross total resection, 62% of patients received conformal RT (vs 29% for intensity modulated RT and 8% for proton beam RT), 62.4% of patients received a dose >54 Gy, and 71% received chemotherapy. Of the 84 relapses, 75% were local. The cumulative incidence of local relapse was 24.4% (95% CI 18.2-31.2) at 3 years and 31.3% (95% CI 24-38.9) at 5 years. The 5-year disease-free survival (DFS) and overall survival rates were 50.4% (95% CI 42.2-58) and 71.4% (95% CI 63.1-78.2). Tumor grade was the only prognostic factor for local relapse and DFS. Tumor grade, age, and extent of resection were independent prognostic factors for overall survival. CONCLUSIONS: We confirmed several clinical and tumoral prognostic factors in a large French multicenter study. DFS for intracranial ependymoma remains low, and new biological and imaging markers are needed to distinguish among different subtypes, adapt treatments, and improve survival.
Authors: Santhosh A Upadhyaya; Giles W Robinson; Arzu Onar-Thomas; Brent A Orr; Catherine A Billups; Daniel C Bowers; Anne E Bendel; Tim Hassall; John R Crawford; Sonia Partap; Paul G Fisher; Ruth G Tatevossian; Tiffany Seah; Ibrahim A Qaddoumi; Anna Vinitsky; Gregory T Armstrong; Noah D Sabin; Christopher L Tinkle; Paul Klimo; Danny J Indelicato; Frederick A Boop; Thomas E Merchant; David W Ellison; Amar Gajjar Journal: Neuro Oncol Date: 2019-10-09 Impact factor: 12.300
Authors: Pierre Leblond; Maura Massimino; Martin English; Timothy A Ritzmann; Lorenza Gandola; Gabriele Calaminus; Sophie Thomas; David Pérol; Julien Gautier; Richard G Grundy; Didier Frappaz Journal: Front Neurol Date: 2022-06-02 Impact factor: 4.086