Treatment Outcomes of Patients with Ependymoma Receiving Radiotherapy: A Single Institution Experience.

IF 2.5 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2024-03-12 DOI:10.1159/000538321

Tiffany Ting-Fong Liu, Jason Chia-Hsien Cheng, Yu-Hsuan Chen, Feng-Ming Hsu, Keng-Hsueh Lan, Chao-Yuan Huang, Chun-Wei Wang, Sung-Hsin Kuo

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Abstract

Introduction: The study explored the failure pattern and clinical outcomes in patients with ependymoma undergoing radiotherapy.

Methods: Between January 2004 and June 2022, we included 32 patients with ependymoma who underwent radiotherapy as part of the multimodality treatment at our institution. Of these, 27 (84.4%) underwent adjuvant radiotherapy, four received radiotherapy after local recurrence, and one received definitive CyberKnife radiotherapy (21 Gy in three fractions). The median prescribed dose was 54 Gy in patients who received conventional radiotherapy. We analyzed the local progression-free survival (LPFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), overall survival (OS), and potential prognostic factors.

Results: The median age was 29.8 years. Approximately 28.1% were pediatric patients. Fifteen tumors (46.9%) were World Health Organization (WHO) grade II, 10 (31.3%) were WHO grade III, and seven (22.8%) were WHO grade I. Among them, 15 patients (46.9%) had posterior fossa tumors, 10 (31.3%) had supratentorial tumors, and seven (22.8%) had spinal tumors. Of the 31 patients who underwent upfront surgical resection, 19 (61.3%) underwent gross total resection or near total resection. Seventeen of 19 patients with first failures (89.5%) had isolated local recurrences. Of the 19 patients with disease progression, 11 (57.9%) were disease-free or had stable disease after salvage therapy, and five (26.3%) had disease-related mortality. Most of the first local recurrences after radiotherapy occurred in the infield (13 of 16, 81.3%). The 5-year LPFS, DMFS, PFS, and OS rates were 48.5%, 89.6%, 45.1%, and 88.4%, respectively, at a median follow-up of 6.25 years. Subtotal resection was associated with poorer LPFS and PFS in patients with intracranial ependymoma (hazard ratio = 3.69, p = 0.018 for LPFS; hazard ratio = 3.20, p = 0.029 for PFS).

Conclusion: Incorporating radiotherapy into multimodal treatment has led to favorable outcomes in patients with ependymoma, and the extent of resection is a prognostic factor for the local control of intracranial ependymoma.

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Ependymoma 患者接受放射治疗的疗效：单个机构的经验

简介：该研究探讨了接受放射治疗的脑外胶质瘤患者的失败模式和临床疗效：该研究探讨了接受放射治疗的脑外胚瘤患者的失败模式和临床结果：2004年1月至2022年6月期间，我院共收治了32例接受放疗的附脑瘤患者，作为多模式治疗的一部分。其中27人（84.4%）接受了辅助放疗，4人在局部复发后接受了放疗，1人接受了最终的CyberKnife放疗（21 Gy，分三次）。接受传统放疗的患者的中位处方剂量为54 Gy。我们分析了患者的局部无进展生存期（LPFS）、无远处转移生存期（DMFS）、无进展生存期（PFS）、总生存期（OS）以及潜在的预后因素：中位年龄为 29.8 岁。中位年龄为29.8岁，约28.1%为儿童患者。其中，15 名患者（46.9%）为后窝肿瘤，10 名患者（31.3%）为幕上肿瘤，7 名患者（22.8%）为脊柱肿瘤。在接受前期手术切除的 31 例患者中，19 例（61.3%）接受了全切或近全切。19名首次手术失败的患者中有17名（89.5%）出现了孤立的局部复发。在疾病进展的 19 例患者中，11 例（57.9%）在抢救治疗后无疾病或疾病稳定，5 例（26.3%）出现疾病相关死亡。放疗后的首次局部复发大多发生在内野（16 例中有 13 例，占 81.3%）。中位随访6.25年，5年LPFS、DMFS、PFS和OS率分别为48.5%、89.6%、45.1%和88.4%。在颅内上皮瘤患者中，次全切除与较差的LPFS和PFS相关（LPFS的危险比=3.69，P=0.018；PFS的危险比=3.20，P=0.029）：结论：将放疗纳入多模式治疗可为附脑瘤患者带来良好的预后，切除范围是颅内附脑瘤局部控制的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.