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The results of surgery, with or without radiotherapy, for primary spinal myxopapillary ependymoma: a retrospective study from the rare cancer network

Pica, Alessia
Miller, Robert
Villà, Salvador
Kadish, Sidney P.
Anacak, Yavuz
Abusaris, Huda
Ozyigit, Gokhan
Baumert, Brigitta G.
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Published in International Journal of Radiation Oncology, Biology, Physics. 2009, vol. 74, no. 4, p. 1114-20
Abstract PURPOSE: The aim of this study was to assess the outcome of patients with primary spinal myxopapillary ependymoma (MPE). MATERIALS AND METHODS: Data from a series of 85 (35 females, 50 males) patients with spinal MPE were collected in this retrospective multicenter study. Thirty-eight (45%) underwent surgery only and 47 (55%) received postoperative radiotherapy (RT). Median administered radiation dose was 50.4 Gy (range, 22.2-59.4). Median follow-up of the surviving patients was 60.0 months (range, 0.2-316.6). RESULTS: The 5-year progression-free survival (PFS) was 50.4% and 74.8% for surgery only and surgery with postoperative low- (<50.4 Gy) or high-dose (>or=50.4 Gy) RT, respectively. Treatment failure was observed in 24 (28%) patients. Fifteen patients presented treatment failure at the primary site only, whereas 2 and 1 patients presented with brain and distant spinal failure only. Three and 2 patients with local failure presented with concomitant spinal distant seeding and brain failure, respectively. One patient failed simultaneously in the brain and spine. Age greater than 36 years (p = 0.01), absence of neurologic symptoms at diagnosis (p = 0.01), tumor size >or=25 mm (p = 0.04), and postoperative high-dose RT (p = 0.05) were variables predictive of improved PFS on univariate analysis. In multivariate analysis, only postoperative high-dose RT was independent predictors of PFS (p = 0.04). CONCLUSIONS: The observed pattern of failure was mainly local, but one fifth of the patients presented with a concomitant spinal or brain component. Postoperative high-dose RT appears to significantly reduce the rate of tumor progression.
Keywords AdolescentAdultAgedAnalysis of VarianceBrain Neoplasms/secondaryChildCombined Modality Therapy/methodsDisease ProgressionDisease-Free SurvivalEpendymoma/mortality/radiotherapy/secondary/surgeryFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalRadiotherapy/adverse effectsRadiotherapy DosageRetrospective StudiesSpinal Neoplasms/mortality/radiotherapy/surgeryTreatment FailureYoung Adult
PMID: 19250760
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Research group Groupe Weber Damien (oncologie pédiatrique) (894)
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PICA, Alessia et al. The results of surgery, with or without radiotherapy, for primary spinal myxopapillary ependymoma: a retrospective study from the rare cancer network. In: International Journal of Radiation Oncology, Biology, Physics, 2009, vol. 74, n° 4, p. 1114-20. https://archive-ouverte.unige.ch/unige:5463

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Deposited on : 2010-03-17

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