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Non-metastatic childhood ependymomas

C Carrie1, C Mottolese, E Bouffet

  • 1Department of Radiotherapy-Oncology, Centre Léon Bérard, Lyon, France.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|August 1, 1995
PubMed
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Recurrences of childhood intracranial ependymomas are mostly local, even with high-dose radiation. Prophylactic craniospinal irradiation may be unnecessary; improved local control methods are needed.

Area of Science:

  • Pediatric Neuro-oncology
  • Radiation Oncology
  • Clinical Outcomes Research

Background:

  • Intracranial ependymomas are rare pediatric brain tumors with debated optimal treatment strategies.
  • Understanding recurrence patterns is crucial for refining postoperative management and radiotherapy fields.
  • Previous studies show varied outcomes and relapse sites, necessitating further investigation.

Purpose of the Study:

  • To analyze the recurrence patterns of childhood intracranial ependymomas.
  • To evaluate the implications of recurrence patterns on the extent of radiotherapy fields.
  • To inform optimal postoperative treatment strategies for these tumors.

Main Methods:

  • Retrospective analysis of 37 pediatric patients (aged 1-14 years) treated between 1975 and 1993.

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  • Patients received postoperative radiation therapy (28/37) and/or chemotherapy (26/37).
  • Median follow-up was 6 years, with survival and event-free survival assessed at 5 and 10 years.

    • Main Results:

    • Overall and event-free survival rates at 5 and 10 years were 40%.
    • Eighteen children relapsed, with 14 local recurrences and 4 distant recurrences.
    • Tumor grade and lack of postoperative radiation were associated with higher relapse rates, though not statistically significant.

    Conclusions:

    • The majority of recurrences were local, even with radiation doses >= 50 Gy.
    • Findings suggest prophylactic craniospinal irradiation may be superfluous for intracranial ependymomas.
    • Future research should focus on advanced techniques like 3D conformal radiotherapy or hyperfractionation for enhanced local control.