Adjunctive treatment of myxopapillary ependymoma running head: Myxopapillary ependymoma

Abstract

Myxopapillary ependymoma are rare tumors and optimal therapeutic strategy is remained controversial. The main treatments for myxopapillary ependymoma tumors include surgery and radiotherapy. Hence, the present study aimed to review adjuvant treatment of myxopapillary ependymoma, focusing on spinal myxopapillary ependymoma. The information sources of all articles were the English authoritative databases including PubMed, Web of science, Scopus, Science direct and Google scholar. In this review study, the keywords including adjuvant, treatment, myxopapillary and ependymoma were selected from MeSH medical library. Related articles were published from 2000 to 2020. Given radiation tolerance in the spinal cord is 10-15% lower than that of the brain, it also should be noted that with increased dose and scope of therapeutic field, the corresponding risks are increased, as well. Also, chemotherapy has never been used as the primary treatment approach. Radiotherapy’s value is considered while involving with sensitive areas where chemotherapy is also recommended. Gross total resection is the preferred primary treatment. But the role of adjuvant radiotherapy is debated in different tumor and patient scenarios and no standard treatment strategy had been defined yet. The bottom line is that as long as cellular and molecular methods or gene therapy can be used in the treatment of myxopapillary ependymoma, all the studies confirm that the best treatment method is still wide surgical resection as much as possible.

Giant Myxopapillary Ependymoma with Multi-Site Neural Axis Metastases: A Rare Case with Suboptimal Outcome

“…Comparing our clinical case with previously published articles, we observe a limited number of published cases of myxopapillary ependymoma [ 13 , 14 ], and even fewer clinical cases with such giant tumors.…”

“…The tumor’s location near critical structures, such as nerves and blood vessels, can make surgical removal quite complicated [ 13 , 14 ]. While surgery is often the primary treatment, achieving complete resection without causing neurological deficits is a major challenge for neurosurgeons [ 15 ].…”

Outcomes and Pattern of Care for Spinal Myxopapillary Ependymoma in the Modern Era—A Population-Based Observational Study

“…Another retrospective review of 58 patients undergoing surgical resection found a trend toward improved disease control with the utilization of adjuvant radiotherapy for disease with capsular invasion [ 15 ]. In a contemporary literature review of adjuvant management strategies for MPE, Jahanbakhshi et al identified mixed data for adjuvant radiotherapy while confirming maximal surgical resection as the most important therapy for improving patient outcomes [ 16 ].…”

“…In general, the consensus optimal treatment strategy is similar to ependymoma at large, wherein maximal safe surgical resection is recommended [ 11 , 12 , 13 ]. The role of chemotherapy and radiotherapy remains controversial [ 14 , 15 , 16 ].…”