Journal article
Progression-free survival of children with localized ependymoma treated with intensity-modulated radiation therapy or proton-beam radiation therapy
Cancer, Vol.123(13), pp.2570-2578
07/01/2017
DOI: 10.1002/cncr.30623
PMID: 28267208
Abstract
The treatment for childhood intracranial ependymoma includes maximal surgical resection followed by involved-field radiotherapy, commonly in the form of intensity-modulated radiation therapy (IMRT). Proton-beam radiation therapy (PRT) is used at some centers in an effort to decrease long-term toxicity. Although protons have the theoretical advantage of a minimal exit dose to the surrounding uninvolved brain tissue, it is unknown whether they have the same efficacy as photons in preventing local recurrence.
A retrospective review of medical records from September 2000 to April 2013 was performed. Seventy-nine children with newly diagnosed localized intracranial ependymomas treated with either IMRT (n = 38) or PRT (n = 41) were identified, and progression-free survival (PFS) was analyzed with Kaplan-Meier and Cox multivariate analyses.
The median age at diagnosis was 3.7 years for all patients (range, 0.4-18.7 years). There were 54 patients with infratentorial tumors (68% of the total population). Patients treated with PRT were younger (median age, 2.5 vs 5.7 years; P = .001) and had a shorter median follow-up (2.6 vs 4.9 years; P < .0001). Gross total resection (GTR) was achieved in 67 patients (85%) and was more frequent in the PRT group versus the IMRT group (93% vs 76%; P = .043). The 3-year PFS rates were 60% and 82% with IMRT and PRT, respectively (P = .031).
Children with localized ependymomas treated with PRT have a 3-year PFS rate comparable to that of children treated with IMRT. This analysis suggests that local control is not compromised by the use of PRT. The data also support GTR as the only prognostic factor for PFS. Cancer 2017;123:2570-78. © 2017 American Cancer Society.
Details
- Title: Subtitle
- Progression-free survival of children with localized ependymoma treated with intensity-modulated radiation therapy or proton-beam radiation therapy
- Creators
- Mariko Sato - University of Iowa Children's Hospital, Iowa City, IowaJillian R Gunther - The University of Texas MD Anderson Cancer Center, Houston, TexasAnita Mahajan - The University of Texas MD Anderson Cancer Center, Houston, TexasEunji Jo - Biostatistics and Informatics Shared Resource, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TexasArnold C Paulino - The University of Texas MD Anderson Cancer Center, Houston, TexasAdekunle M Adesina - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasJeremy Y Jones - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasLeena M Ketonen - The University of Texas MD Anderson Cancer Center, Houston, TexasJack M Su - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasM Fatih Okcu - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasSoumen Khatua - The University of Texas MD Anderson Cancer Center, Houston, TexasRobert C Dauser - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasWilliam E Whitehead - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TexasJeffrey Weinberg - The University of Texas MD Anderson Cancer Center, Houston, TexasMurali M Chintagumpala - Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas
- Resource Type
- Journal article
- Publication Details
- Cancer, Vol.123(13), pp.2570-2578
- DOI
- 10.1002/cncr.30623
- PMID
- 28267208
- NLM abbreviation
- Cancer
- ISSN
- 0008-543X
- eISSN
- 1097-0142
- Language
- English
- Date published
- 07/01/2017
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984093508302771
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