SINGLE-CENTER EXPERIENCE AND LITERATURE REVIEW OF RADIOTHERAPY OUTCOMES FOR ADULT EPENDYMOMAS


Creative Commons License

Üçüncü Kefeli A., Yaprak Bayrak B., Aksu M. G.

Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, cilt.10, sa.2, ss.53-61, 2024 (Hakemli Dergi)

Özet

Objective: To retrospectively determine the long-term outcome of adult intracranial and spinal ependymoma patients treated with postoperative radiation therapy after surgery. Methods: Fourteen adult patients who underwent radiotherapy after surgery at a single center between 1999 and 2022 were included. The endpoints analyzed were overall survival and progression-free survival, together with prognostic factors. Results: The median (range) age was 29.5 (23–58) years. The majority (71.4%) of the tumors were located in the spinal canal and gross total resection was performed in nine (64.3%) patients. Six patients were irradiated after recurrence (spinal n=4, intracranial n=2) of whom three had myxopapillary and two had anaplastic histology. Patients were followed up for a median duration of 106.5 (13-172) months. Overall, 4 patients (intracranial n=3, spinal n=1) had recurrences and died after radiotherapy as a direct result of disease progression during the follow-up period. All of these intracranial tumors exhibited anaplastic histology and the spinal tumor was myxopapillary type. Patients with intracranial lesions had a 5-year survival of 50% and no patient was alive on the 10th year, compared with 5- and 10-year overall survival of 87.5 % for patients with spinal tumors. Patients with spinal tumors had a 5- and 10-year progression-free survival rate of 52.5%, while those with intracranial lesions had a rate of 25%. Conclusion: In low-grade spinal ependymomas radiotherapy appears to control disease, even after recurrence. For myxopapillary ependymoma patients, in subtotally resected intracranial and all high-grade tumors, regardless of the extent of resection, adjuvant radiotherapy should be administered.