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Outcome
of radiation therapy for intramedullary spinal cord glioma-Wayne State
University experience
A.
E. Sloan, S. Lo, K. Levin, A. Frazier, L. Gaspar, Karmanos Cancer Institute,
Wayne State
Karmanos
Cancer Inst, Detroit, MI; Karmanos Cancer Institute, Detroit, MI
Introduction.
To review the outcome of radiation therapy for spinal cord glioma.
Methods.
From the database of our institution, we identified 18 patients (7 male and 11
female) with a diagnosis of spinal cord glioma (14 with astrocytoma and 4 with
ependymoma) treated with external beam radiation therapy (RT).
The radiation dose was 5040 cGy (range 4140-5604 cGy) in 28 fractions (range
23-31 fractions).
The median number of segments involved was 4.5 (range 1-19).
The median age was 21.5 years (range 3-58 years).
Four, three and 11 patients underwent biopsy, subtotal resection and complete
resection, respectively.
Among the 14 patients with astrocytoma, two, 11 and one had high, intermediate
and low grade astrocytoma.
Results.
The median follow-up was 61 months (range 2-162.3 months).
The 5- and 10-year overall survival (OS) was 64.9% and 58.4%.
The 5- and 10-year disease specific survival (DSS) was 64.9% and 64.9%.
The 5- and 10-year local control (LC) was 58.7% and 58.7%.
For patients with astrocytoma, the 5- and 10-year overall survival was 57.1% and
50%; the 5- and 10-year DSS was 57.1% and 57.1%.
The 5- and 10-year LC was 50% and 50%.
The number of segments involved (</= 5 vs. > 5) did not impact on DSS.
Radiation dose also did not impact on DSS.
Only one of the four patients with ependymoma failed after RT.
Conclusions.
No radiation dose response was demonstrated for spinal cord glioma.
The long term survival after RT was similar to what was reported in the
literature.
Intramedullary spinal cord ependymoma had a more favorable outcome than its
astrocytoma counterpart.
Innovative treatments are to be explored to improve the outcome for the latter.
© Copyright 2003
American Society of Clinical Oncology All rights
reserved worldwide
Source:
http://www.asco.org/ac/1,1003,_12-002489-00_18-002003-00_19-00101582-00_29-00A,00.asp?cat=CNS+Tumors&parent=
Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4 |
