Related Experiment Videos
Treatment of intracranial ependymoma by surgery alone
1Department of Neurology, Beth Israel Medical Center, New York, N.Y., USA.
Insights
Deferring radiotherapy after complete surgical removal of pediatric intracranial ependymoma is safe. Most children remained disease-free, and recurrences were treatable with further surgery and radiotherapy.
Area of Science:
- Pediatric neuro-oncology
- Radiation oncology
- Neurosurgery
Background:
- Ependymomas are a significant cause of brain tumors in children.
- Standard treatment often includes surgery followed by radiotherapy.
- The role of radiotherapy in localized ependymoma after gross total resection requires further investigation.
Purpose of the Study:
- To evaluate the safety and efficacy of withholding radiotherapy in pediatric patients with intracranial ependymoma.
- To assess outcomes in patients who underwent gross total resection and deferred radiotherapy.
- To determine recurrence patterns and salvageability in this patient cohort.
Main Methods:
- Prospective study of children over age 3 diagnosed with intracranial ependymoma.
- Inclusion criteria: radiographically confirmed gross total resection.
- Data collected on disease recurrence, salvage treatment, and survival.
Main Results:
- Ten patients were eligible and consented to participate.
- Seven patients remained disease-free without additional treatment.
- Three patients experienced recurrence; two were successfully treated with surgery and radiotherapy, with no deaths.
Conclusions:
- Radiotherapy deferral is a safe strategy for pediatric supratentorial ependymomas following gross total resection.
- Recurrences are typically local and amenable to salvage therapy.
- This approach may help reduce long-term treatment-related toxicities in select pediatric patients.
Objective:
This study aimed to determine the safety of deferring radiotherapy in pediatric intracranial ependymoma following a radiographically confirmed gross total resection in patients with localized disease.
Methods:
Children over age 3 were recruited prospectively from 1990 to 1997, following a surgical impression and radiologic confirmation of a gross total resection of an intracranial ependymoma.
Results:
10/32 cases of intracranial ependymomas were both eligible and gave consent. 7 remain free of disease without further intervention. 3 recurred, 2 were salvaged with surgery and radiotherapy, none died.
Conclusions:
Deferral of radiotherapy following gross total resection alone is a safe option in supratentorial ependymomas. The pattern of recurrence is usually local and patients may be salvaged with additional surgery with or without radiotherapy.