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Scientific article
English

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

Published inInternational journal of radiation oncology, biology, physics, vol. 74, no. 4, p. 1114-1120
Publication date2009
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
  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Brain Neoplasms/secondary
  • Child
  • Combined Modality Therapy/methods
  • Disease Progression
  • Disease-Free Survival
  • Ependymoma/mortality/radiotherapy/secondary/surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Radiotherapy/adverse effects
  • Radiotherapy Dosage
  • Retrospective Studies
  • Spinal Neoplasms/mortality/radiotherapy/surgery
  • Treatment Failure
  • Young Adult
Citation (ISO format)
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. 1114–1120. doi: 10.1016/j.ijrobp.2008.09.034
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Article (Published version)
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ISSN of the journal0360-3016
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