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English

Intensity modulated radiation therapy or stereotactic fractionated radiotherapy for infratentorial ependymoma in children: a multicentric study

Contributors

Weber, Damien; Zilli, Thomas; Do, Hans Peter; Nouet, Philippe; Gumy Pause, Fabienne; Pica, Alessia

Published in

Journal of neuro-oncology, vol. 102, no. 2, p. 295-300

Collection

  • Open Access - Licence nationale Springer

Publication date

2011

Abstract

This study was to evaluate the treatment dosimetry, efficacy and toxicity of intensity modulated radiation therapy (IMRT) and fractionated stereotactic radiotherapy (FSRT) in the management of infratentorial ependymoma. Between 1999 and 2007, seven children (median age, 3.1 years) with infratentorial ependymoma were planned with either IMRT (3 patients) or SFRT (4 patients), the latter after conventional posterior fossa irradiation. Two children underwent gross total resection. Median prescribed dose was 59.4 Gy (range, 55.8-60). The median follow-up for surviving patients was 4.8 years (range, 1.3-8). IMRT (median dose, 59.4 Gy) and FSRT (median dose, 55.8 Gy) achieved similar optimal target coverage. Percentages of maximum doses delivered to the cochleae (59.5 vs 85.0% Gy; P = 0.05) were significantly inferior with IMRT, when compared to FSRT planning. Percentages of maximum doses administered to the pituitary gland (38.2 vs 20.1%; P = 0.05) and optic chiasm (38.1 vs 14.1%; P = 0.001) were, however, significantly higher with IMRT, when compared to FSRT planning. No recurrences were observed at the last follow-up. The estimated 3-year progression-free survival and overall survival were 87.5 and 100%, respectively. No grade >1 acute toxicity was observed. Two patients presented late adverse events (grade 2 hypoacousia) during follow-up, without cognitive impairment. IMRT or FSRT for infratentorial ependymomas is effective and associated with a tolerable toxicity level. Both treatment techniques were able to capitalize their intrinsic conformal ability to deliver high-dose radiation. Larger series of patients treated with these two modalities will be necessary to more fully evaluate these delivery techniques.

Keywords

  • Child
  • Child, Preschool
  • Dose Fractionation
  • Ependymoma/radiotherapy
  • Female
  • Humans
  • Infant
  • Male
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated
  • Survival Rate
  • Treatment Outcome

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

WEBER, Damien et al. Intensity modulated radiation therapy or stereotactic fractionated radiotherapy for infratentorial ependymoma in children: a multicentric study. In: Journal of neuro-oncology, 2011, vol. 102, n° 2, p. 295–300. doi: 10.1007/s11060-010-0318-2

Main files (1)

Article (Published version)

Identifiers

Journal ISSN

0167-594X
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291downloads

Technical informations

Creation

19/12/2012 13:51:00

First validation

19/12/2012 13:51:00

Update

14/03/2023 19:53:55

Status update

14/03/2023 19:53:55

Last indexation

30/10/2024 08:14:54
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