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Combined treatment of fourth ventricle ependymomas: report of 26 cases
D Spagnoli1, G Tomei, G Ceccarelli
1Institute of Neurosurgery, University of Milan, Ospedale Maggiore Policlinico I.R.C.C.S., Milan, Italy.
Background:
This study investigated the relevance of prognostic factors and the impact of histological features in posterior fossa ependymoma.
Methods:
The charts of 26 patients (aged 1-59 years, mean 20.6 years; 11 adults) with posterior fossa ependymoma operated on between January 1983 and December 1994 were reviewed and patients followed up (mean: 93 months).
Results:
Gross total resection was performed in 18 patients (69%), subtotal in seven patients (27%), biopsy in one patient (4%). One patient (3.8%) developed respiratory complications and died. All patients underwent posterior fossa radiotherapy (5000 cGy) after surgery. Four children first received chemotherapy and then radiotherapy only when at least 3 years old. Eleven patients (42%) received radiotherapy and subsequently chemotherapy. The 5-year survival rate was 90% for adults and 40% for children (
Conclusions:
This review suggests that a) younger patients (