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A multicenter study of the prognosis and
treatment of adult brain ependymal tumors
Reni M, Brandes AA, Vavassori V, Cavallo G, Casagrande F, Vastola F, Magli A,
Franzin A, Basso U, Villa E
Department of Radiochemotherapy, San Raffaele Hospital Scientific
Institute, Milan, Italy. reni.michele@hsr.it
Background. The current analysis of outcomes in a large series of adult
patients with intracranial ependymal tumors contributes to the characterization
of the primary prognostic factors and to the therapeutic management of this rare
disease, for which limited information is available in the literature.
Methods. The authors analyzed data on patient and tumor
characteristics, treatment, and survival in a series of 70 patients age > 17
years with pathologic diagnoses of brain ependymal tumors from 4
institutions.
Results. The 5- and 10-year overall survival (OS) rates (+/- standard
errors) were 67% +/- 6% and 50% +/- 8%, respectively.
The 5- and 10-year failure-free survival (FFS) rates were 43% +/- 7% and 24% +/-
6%, respectively.
Younger age and infratentorial tumor location were associated with longer
survival.
Among patients with Grade 2 ependymoma (n = 51), 21 (41%) received no
postsurgical treatment.
These 21 patients had a 5-year OS rate of 78% +/- 10% and a 10-year OS rate of
68% +/- 13%; the 5- and 10-year FFS rates for these patients were 47% +/- 12%
and 12% +/- 11%, respectively.
Twenty-six patients with Grade 2 ependymoma (51%) received postoperative
radiotherapy (RT).
These 26 patients had a 5-year OS rate of 71% +/- 9% and a 10-year OS rate of
59% +/- 11%; the 5- and 10-year FFS rates for these patients were 54% +/- 10%
and 34% +/- 10%, respectively.
Among patients with Grade 2 ependymoma, neither OS nor FFS differed
significantly between those who did not receive postoperative RT and those who
did; however, these two groups were heterogeneous with respect to prognostic
factors.
On multivariate analysis, RT use exhibited a trend toward improved OS and was
significantly predictive of improved FFS.
Conclusions. The current analysis does not rule out the possibility
that deferral of RT at the time of recurrence could have a detrimental effect on
FFS or OS in patients with Grade 2 ependymoma, regardless of the degree of
ablation.
The role of postoperative RT for patients who undergo imaging-based macroscopic
total resection remains to be addressed.
Copyright 2004 American Cancer Society.
PMID: 15022290 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15022290
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