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Survival after therapy for pediatric ependymoma in a tertiary care center in Saudi Arabia
Syed Nizam Shah1, Sadeq Wasil Al-Dandan2, Muhammad Shuja3
1From the Department of Pediatric Hematology and Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.
Insights
This study analyzed pediatric intracranial ependymoma in Saudi Arabia, finding outcomes comparable to international data. Improving survival may involve reducing radiation therapy delays and incorporating molecular staging for better pediatric brain tumor treatment.
Area of Science:
- Pediatric Oncology
- Neuro-Oncology
- Clinical Outcomes Research
Background:
- Limited data exists on pediatric intracranial ependymoma in Saudi Arabia.
- Understanding demographic characteristics and treatment outcomes is crucial for this population.
Purpose of the Study:
- To investigate the characteristics of pediatric ependymoma in Saudi Arabia.
- To evaluate the outcomes of various treatment modalities for pediatric intracranial ependymoma.
Main Methods:
- Retrospective study conducted at a tertiary care center.
- Included 22 children under 14 treated between 2006-2015.
- Kaplan-Meier curves used to estimate event-free survival (EFS) and overall survival (OS).
Main Results:
- Gross total resection achieved in 42.9% of cases; subtotal resection in 42.9%.
- Radiotherapy (RT) administered to 77.3% of patients (median dose 55.8 Gy).
- Cumulative OS was 44.5% and cumulative EFS was 18.6% over a median follow-up of 5.38 years.
Conclusions:
- Outcomes for pediatric intracranial ependymoma in Saudi Arabia are comparable to international benchmarks.
- Reducing delays in radiation therapy and implementing molecular staging could enhance treatment effectiveness.
- Further research is needed due to limitations such as small sample size and lack of molecular data.
Background:
There is limited data from Saudi Arabia on the demographic characteristics, outcomes and effectiveness of different treatment modalities in children with intracranial ependymoma.
Objective:
Study the characteristics of pediatric ependymoma and outcomes of treatment modalities in Saudi Arabia.
Design:
Retrospective.
Setting:
Tertiary care center.
Patients And Methods:
Children with intracranial ependymoma who were younger than 14 years of age and treated between 2006 and 2015 were included in the study. Patients with prior radiation, chemo-therapy, or surgical resection at other centers were excluded.
Main Outcome Measures:
Kaplan-Meier survival curves were used to estimate the event-free (EFS) and overall survival (OS) rates of the patients.
Sample Size:
22.
Results:
Of the 22 children, 4 (18.2%) were less than three years old. All intracranial ependymomas had upfront surgical resection of the primary tumor. Gross total resection was achievable in 9 (42.9%) cases and subtotal resection in another 9 (42.9%). Near-total resection was done in 3 (14.3%) cases. Median time from surgery to start of radiotherapy was 62 days. RT was given to 17 (77.3%) patients. Both mean and median RT dose was 55.8 Gy. Only 5 (22.7%) of the children received chemotherapy. The median duration of follow-up was 5.38 years and the median time for EFS was 2.27 years. The cumulative OS rate of the study was 44.5%. The cumulative EFS survival rate of the study was 18.6%. Among demographic, pathological, radiological features, none had a statistically significant effect on the survival.
Conclusions:
The outcomes are comparable to those reported by international investigators for similar populations. Further improvements can be achieved by avoiding delays in radiation therapy and adding molecular staging.
Limitations:
The limited number of cases, retrospective nature, lack of molecular biology and size of the tumors.
Conflict Of Interest:
None.
