Patterns of relapse for children with localized intracranial ependymoma Journal Article
| Authors: | De, B.; Khakoo, Y.; Souweidane, M. M.; Dunkel, I. J.; Patel, S. H.; Gilheeney, S. W.; De Braganca, K. C.; Karajannis, M. A.; Wolden, S. L. |
| Article Title: | Patterns of relapse for children with localized intracranial ependymoma |
| Abstract: | We examined patterns of relapse and prognostic factors in children with intracranial ependymoma. Records of 82 children diagnosed with localized intracranial ependymoma were reviewed. 52% first presented to our institution after relapse. Median age at initial diagnosis was 4 years (range 0–18 years). Gender was 55% male. Initial tumor location was infratentorial in 71% and supratentorial in 29%. Histology was WHO Grade II in 32% and Grade III in 68%. As part of definitive management, 99% had surgery, 70% received RT (26% 2D/3D-conformal RT[CRT], 22% intensity-modulated RT [IMRT], 22% proton), and 37% received chemotherapy. Median follow-up was 4.6 years (range 0.2–32.9). Overall, 74% of patients relapsed (50% local, 17% distant, 7% local + distant) at a median 1.5 (range 0.1–17.5) years. Five-year OS and FFS for patients presenting prior to relapse are 70% (95% confidence interval [CI], 50–83%) and 48% (95% CI 30–64%), respectively. On log-rank, superior overall survival (OS) was demonstrated for gross total resection (p = 0.03). Superior failure-free survival (FFS) was demonstrated for age < 5 years (p = 0.04). No difference in OS or FFS was found between 2D/3D-CRT versus IMRT/proton (p > 0.05). On multivariate analysis, age ≤ 5 was independently associated with a lower risk of death and failure versus older patients (p < 0.05). Contrary to previous reports, young age may not be a poor prognostic factor in patients who can tolerate intensive treatment. Future studies examining patients stratified by clinical and molecular attributes are warranted. © 2018, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | chemotherapy; surgery; radiation therapy; ependymoma; cns tumors |
| Journal Title: | Journal of Neuro-Oncology |
| Volume: | 138 |
| Issue: | 2 |
| ISSN: | 0167-594X |
| Publisher: | Springer |
| Date Published: | 2018-06-01 |
| Start Page: | 435 |
| End Page: | 445 |
| Language: | English |
| DOI: | 10.1007/s11060-018-2815-7 |
| PROVIDER: | scopus |
| PUBMED: | 29511977 |
| PMCID: | PMC6756472 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2018 -- Source: Scopus |
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141Karajannis -
371Dunkel -
149Khakoo -
560Wolden -
219Souweidane -
32De Braganca -
78Gilheeney -
15Patel -
10De
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