Dorothee Gramatzki1, Jörg Felsberg2, Bettina Hentschel3, Oliver Bähr4, Manfred Westphal5, Gabriele Schackert6, Jörg Christian Tonn7,8, Ulrich Herrlinger9, Markus Loeffler3, Torsten Pietsch10, Joachim Peter Steinbach4, Guido Reifenberger2,11, Patrick Roth1, Michael Weller1. 1. Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland. 2. Institute of Neuropathology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. 3. Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany. 4. Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany. 5. Department of Neurosurgery, University of Hamburg, Hamburg, Germany. 6. Department of Neurosurgery, University of Dresden, Dresden, Germany. 7. Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany. 8. German Cancer Consortium, Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany. 9. Department of Neurology, Division of Clinical Neurooncology, University Hospital Bonn, Bonn, Germany. 10. Department of Neuropathology, DGNN Brain Tumor Reference Center, University Hospital Bonn, Bonn, Germany. 11. German Cancer Consortium, Partner Site Essen/Düsseldorf, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND: The incidence of spinal cord gliomas, particularly in adults is low, and the role of chemotherapy has remained unclear. METHODS: We performed a multicenter, retrospective study of 21 patients diagnosed with spinal cord glioma who received chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by magnetic resonance imaging. Data on radiotherapy were taken into consideration. RESULTS: Thirteen patients were diagnosed with astrocytic gliomas World Health Organization (WHO) grades 1-4, the remaining eight patients with ependymomas WHO grades 1 or 3. Most patients had more than one neurosurgical intervention. Median age at time of first chemotherapy was 33 years (range 21-67 years). Seven patients had chemotherapy combined with radiotherapy as first-line treatment. Two patients had chemoradiotherapy at recurrence, without prior tumor-specific treatment beyond surgery. One patient received chemotherapy alone as first-line treatment and 2 patients had chemotherapy alone at recurrence, without prior treatment. Nine patients had received radiation therapy at an earlier time and chemotherapy was given at time of further recurrences. Best responses in astrocytomas were as follows: chemotherapy alone-2 stable disease (SD) and 3 progressive disease (PD); chemoradiotherapy-1 complete response, 3 SD, and 4 PD. Best responses in ependymomas were as follows: chemotherapy alone-1 partial response, 5 SD, and 1 PD; chemoradiotherapy-1 SD. CONCLUSIONS: Spinal cord gliomas represent a heterogeneous group of tumors. Survival outcomes in response to chemotherapy in adult spinal cord glioma patients vary substantially, but individual patients appear to derive benefit from chemotherapy.
BACKGROUND: The incidence of spinal cord gliomas, particularly in adults is low, and the role of chemotherapy has remained unclear. METHODS: We performed a multicenter, retrospective study of 21 patients diagnosed with spinal cord glioma who received chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by magnetic resonance imaging. Data on radiotherapy were taken into consideration. RESULTS: Thirteen patients were diagnosed with astrocytic gliomas World Health Organization (WHO) grades 1-4, the remaining eight patients with ependymomas WHO grades 1 or 3. Most patients had more than one neurosurgical intervention. Median age at time of first chemotherapy was 33 years (range 21-67 years). Seven patients had chemotherapy combined with radiotherapy as first-line treatment. Two patients had chemoradiotherapy at recurrence, without prior tumor-specific treatment beyond surgery. One patient received chemotherapy alone as first-line treatment and 2 patients had chemotherapy alone at recurrence, without prior treatment. Nine patients had received radiation therapy at an earlier time and chemotherapy was given at time of further recurrences. Best responses in astrocytomas were as follows: chemotherapy alone-2 stable disease (SD) and 3 progressive disease (PD); chemoradiotherapy-1 complete response, 3 SD, and 4 PD. Best responses in ependymomas were as follows: chemotherapy alone-1 partial response, 5 SD, and 1 PD; chemoradiotherapy-1 SD. CONCLUSIONS: Spinal cord gliomas represent a heterogeneous group of tumors. Survival outcomes in response to chemotherapy in adult spinal cord glioma patients vary substantially, but individual patients appear to derive benefit from chemotherapy.
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