Elise Régnier1, Anne Laprie2, Anne Ducassou2, Stéphanie Bolle3, Stéphane Supiot4, Xavier Muracciole5, Line Claude6, Sophie Chapet7, Bernard Coche-Dequéant8, Céline Vigneron9, Julie Leseur10, Pierre Y Bondiau11, Jean L Habrand12, Valérie Bernier13. 1. Radiation Oncology Institut Jean Godinot, Reims Cedex, France. Electronic address: eregnier@ch-annecygenevois.fr. 2. Oncology Radiotherapy, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France. 3. Oncology Radiotherapy Institut Gustave Roussy, Villejuif, France. 4. Oncology Radiotherapy, ICO René Gauducheau, Saint Herblain, France. 5. Oncology Radiotherapy Hopital de la Timone, Marseille Cedex, France. 6. Oncology Radiotherapy t, Centre Léon Bérard, Lyon, France. 7. Oncology Radiotherapy CHRU Bretonneau, Tours, France. 8. Oncology Radiotherapy Centre Oscar Lambret, Lille, France. 9. Oncology Radiotherapy Centre Paul Strauss, Strasbourg, France. 10. Oncology Radiotherapy Centre Eugène Maquis, Rennes, France. 11. Oncology Radiotherapy Centre Antoine Lacassagne, Nice, France. 12. Oncology Radiotherapy Centre François Baclesse, Caen, France. 13. Oncology Radiotherapy Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France.
Abstract
PURPOSE: This study aimed to evaluate retrospectively the clinical results of re-irradiation for children with a locally recurrent brain ependymoma. METHODS: 33 full-dose re-irradiations were delivered to 31 children with a recurrent brain ependymoma after a standard treatment. Each child was followed up with clinical and MRI examinations. We evaluated overall survival, local recurrence free-survival and short term toxicity according to CTCAE 4.0 scale. RESULTS: With a median follow-up of 37 months (range, 0 to 107), median local recurrence free-survival was 31 months (range, 2 to 63) and median overall survival was 34 months (range, 3 to 63). It was significantly higher in patients who underwent surgery first, compared with re-irradiation only. Cumulated dosimetric data were available for 22 patients. On average, maximal BED to brain stem was 106,2 Gyα/β3 (±35,4) for infratentorial re-irradiation. No acute toxicity grade >2 was reported and 1 case of brain radionecrosis treated successfully with steroids was reported after radiosurgery. CONCLUSION: Local recurrence of brain ependymoma can be treated with full-dose re-irradiation, which can be hypofractionated with an acceptable short term toxicity in spite of high total doses delivered to OARs, especially brain stem.
PURPOSE: This study aimed to evaluate retrospectively the clinical results of re-irradiation for children with a locally recurrent brain ependymoma. METHODS: 33 full-dose re-irradiations were delivered to 31 children with a recurrent brain ependymoma after a standard treatment. Each child was followed up with clinical and MRI examinations. We evaluated overall survival, local recurrence free-survival and short term toxicity according to CTCAE 4.0 scale. RESULTS: With a median follow-up of 37 months (range, 0 to 107), median local recurrence free-survival was 31 months (range, 2 to 63) and median overall survival was 34 months (range, 3 to 63). It was significantly higher in patients who underwent surgery first, compared with re-irradiation only. Cumulated dosimetric data were available for 22 patients. On average, maximal BED to brain stem was 106,2 Gyα/β3 (±35,4) for infratentorial re-irradiation. No acute toxicity grade >2 was reported and 1 case of brain radionecrosis treated successfully with steroids was reported after radiosurgery. CONCLUSION: Local recurrence of brain ependymoma can be treated with full-dose re-irradiation, which can be hypofractionated with an acceptable short term toxicity in spite of high total doses delivered to OARs, especially brain stem.
Authors: Derek S Tsang; Nasim Sarhan; Vijay Ramaswamy; Liana Nobre; Ryan Yee; Michael D Taylor; Cynthia Hawkins; Ute Bartels; Annie Huang; Uri Tabori; David C Hodgson; Eric Bouffet; Normand Laperriere Journal: J Neurooncol Date: 2019-08-29 Impact factor: 4.130