The Results of Surgery, With or Without Radiotherapy, for Primary Spinal Myxopapillary Ependymoma: A Retrospective Study From the Rare Cancer Network

Journal Article · Wed Jul 15 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.09.034· OSTI ID:21276904

Pica, Alessia ^[1]; Miller, Robert ^[2]; VillA, Salvador ^[3]; Kadish, Sidney P ^[4]; Anacak, Yavuz ^[5]; Abusaris, Huda ^[6]; Ozyigit, Gokhan ^[7]; Zaucha, Renata ^[8]; Haller, Guy ^[9]

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1. Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (Switzerland)
2. Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)
3. Catalan Institute of Oncology, Badalona, Barcelona (Spain)
4. University of Massachusetts Medical School, Worcester, MA (United States)
5. Department of Radiation Oncology, Ege University Medical School, Izmir (Turkey)
6. Dr Bernard Verbeeten Instituut, Tilburg (Netherlands)
7. Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Ankara (Turkey)
8. Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland)
9. Department of Clinical Epidemiology and Statistics, Geneva University Hospital, University of Geneva (Switzerland)

Purpose: The aim of this study was to assess the outcome of patients with primary spinal myxopapillary ependymoma (MPE). Materials and Methods: Data from a series of 85 (35 females, 50 males) patients with spinal MPE were collected in this retrospective multicenter study. Thirty-eight (45%) underwent surgery only and 47 (55%) received postoperative radiotherapy (RT). Median administered radiation dose was 50.4 Gy (range, 22.2-59.4). Median follow-up of the surviving patients was 60.0 months (range, 0.2-316.6). Results: The 5-year progression-free survival (PFS) was 50.4% and 74.8% for surgery only and surgery with postoperative low- (<50.4 Gy) or high-dose ({>=}50.4 Gy) RT, respectively. Treatment failure was observed in 24 (28%) patients. Fifteen patients presented treatment failure at the primary site only, whereas 2 and 1 patients presented with brain and distant spinal failure only. Three and 2 patients with local failure presented with concomitant spinal distant seeding and brain failure, respectively. One patient failed simultaneously in the brain and spine. Age greater than 36 years (p = 0.01), absence of neurologic symptoms at diagnosis (p = 0.01), tumor size {>=}25 mm (p = 0.04), and postoperative high-dose RT (p = 0.05) were variables predictive of improved PFS on univariate analysis. In multivariate analysis, only postoperative high-dose RT was independent predictors of PFS (p = 0.04). Conclusions: The observed pattern of failure was mainly local, but one fifth of the patients presented with a concomitant spinal or brain component. Postoperative high-dose RT appears to significantly reduce the rate of tumor progression.

• OSTI ID: 21276904
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 74; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
DIAGNOSIS
FAILURES
MULTIVARIATE ANALYSIS
NEOPLASMS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SURGERY
SYMPTOMS
VERTEBRAE