The Results of Surgery, With or Without Radiotherapy, for Primary Spinal Myxopapillary Ependymoma: A Retrospective Study From the Rare Cancer Network
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (Switzerland)
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)
- Catalan Institute of Oncology, Badalona, Barcelona (Spain)
- University of Massachusetts Medical School, Worcester, MA (United States)
- Department of Radiation Oncology, Ege University Medical School, Izmir (Turkey)
- Dr Bernard Verbeeten Instituut, Tilburg (Netherlands)
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Ankara (Turkey)
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland)
- 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, Vol. 74, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2008.09.034; PII: S0360-3016(08)03541-4; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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