Postoperative radiation therapy for grade II and III intracranial ependymoma

Department of Neurosurgery, Washington University in St. Louis, San Luis, Missouri, United States
International Journal of Radiation OncologyBiologyPhysics (Impact Factor: 4.26). 03/2005; 61(2):387-91. DOI: 10.1016/j.ijrobp.2004.06.002
Source: PubMed


To retrospectively determine the long-term outcome of intracranial ependymoma patients treated with surgery and postoperative radiation therapy.
Sixty patients were treated at our institution between 1964 and 2000. Forty patients had World Health Organization Grade II ependymoma, and 20 patients had Grade III ependymoma. The median patient age was 10.7 years. The majority of patients were male (55%), had infratentorial tumors (80%), and had subtotal resections (72%). Postoperative radiation therapy was delivered to all patients to a median total dose of 50.4 Gy. Craniospinal radiation therapy was used in the earlier era in only 12 patients (20%).
The median follow-up of surviving patients was 12.5 years. The 5-year and 10-year disease-free survival rates for all patients were 58.4% and 49.5%, respectively. The 5-year and 10-year overall survival rates for all patients were 71.2% and 55.0%, respectively. Supratentorial tumor location was independently associated with a worse disease-free survival. Subtotal resection and supratentorial location predicted a worse overall survival, but this failed to reach statistical significance. No statistically significant effect on prognosis was observed with tumor grade, patient age, or radiation dose or volume.
Our long-term follow-up indicates that half of ependymoma patients will have disease recurrences, indicating the need for more effective treatments.

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    • "This was not verified in our study. Radiotherapy is usually reserved for incomplete excised or anaplastic tumors similar to our case.[1011] Venkatramani et al. recently reported that surgery alone may be an acceptable treatment option in completely resected supratentorial ependymoma. "
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