Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro‐Oncology Group

Perilongo, Giorgio; Massimino, Maura; Sotti, Guido; Belfontali, Tiziana; Masiero, Lucia; Rigobello, Luca; Garrè, Maria Luisa; Carli, Modesto; Lombardi, Fabrizio; Solero, C. L.; Sainati, Laura; Canale, Virginia C.; Prever, Adalberto Brach del; Giangaspero, Felice; Andreussi, L.; Mazza, Carlo; Madon, E

doi:10.1002/(sici)1096-911x(199708)29:2<79::aid-mpo3>3.3.co;2-x

Cited by 24 publications

(44 citation statements)

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“…It is often assumed that the absence of radiotherapy in the younger group causes the difference in outcome, but other factors might also be important. Nazar, et al, 25 and Perilongo, et al, 28 report an association of younger age with malignant lesions, infratentorial location, and subtotally resected lesions. On the other hand, Lyons and Kelly 23 and Pollack, et al, 29 found that younger age was a negative prognostic factor regardless of histological findings, extent of resection, and radiotherapy.…”

Section: Discussionmentioning

confidence: 98%

“…Survival rates for childhood intracranial ependymoma reported in the literature vary from 30 to 60% at 5 years. 4,8,25,28,35 In series containing infratentorial lesions in children only, 4 the survival rates tend to be lower, whereas in series including adult and spinal ependymoma, 38,39 much better survival rates are reported. In our patient population, the 5-year survival rate of 68% with and 73% without the perioperative deaths included compares favorably.…”

Section: Discussionmentioning

confidence: 99%

“…Younger age has been shown to be a negative prognostic factor in only half of the reported series (Table 7). 11,18,21,23,25,28,33,34,[35][36][37] This lack of conformity might, in part, be caused by the considerable variation in cut-off age between studies.…”

Section: Discussionmentioning

confidence: 99%

“…In the recent literature most authors, as in our study, have found no correlation between prognosis and histological grade of the tumors. 5,7,13,14,23,[25][26][27][28]34,36,37,41 This may be explained by the use of many different grading systems and the difficulty in differentiating between benign and malignant lesions, but also by histological variability within the tumor. Better-defined histological criteria as well as wider use of mitotic index markers 2,8,30,31 and identification of genetic subtypes 17,42 are probably necessary to identify a prognostically valuable differentiation between tumors.…”

Section: Discussionmentioning

confidence: 99%

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Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy

Veelen¹,

Pierre-Kahn²,

Kalifa³

et al. 2002

Journal of Neurosurgery

121

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Overall survival, intraoperative deaths excluded, was 73 +/- 11% and 51 +/- 14% at 5 and 10 years, respectively. The event-free survival rate at 5 and 10 years was 48 +/- 12% and 46 +/- 12%, respectively. Most of the events were local recurrences. Despite multiple reinterventions, the overall survival rate in this group dropped to 14%. On univariate analysis, the only significant prognostic factors were complete resection and radiotherapy. Both of these factors combined increased the 5- and 10-year survival rates to 93 and 75%, respectively. Age of the patients was not a statistically independent prognostic factor. The patients in the chemotherapy group did not fare as well as those in the radiotherapy group. A subgroup (36%) within the chemotherapy group, however, survived tumor free after a mean follow-up period of 67 months. It is not clear whether this subgroup either responded well to chemotherapy or needed no adjuvant therapy. Further research is warranted to answer this question.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy

Veelen¹,

Pierre-Kahn²,

Kalifa³

et al. 2002

Journal of Neurosurgery

121

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“…Ependymomas accounts approximately for 8-10% of all childhood CNS tumors and the mean age at diagnosis ranges from 50 to 70 months [1][2][3][4]. They are of neuroectodermal origin arising from ependymal cells in the obliterated central canal of the spinal cord, the filum terminale, choroid plexus or white matter adjacent to the highly angulated ventricular surface [5].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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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.

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Ependymal tumors in childhood

Ağaoğlu

Ayan

Dizdar

et al. 2005

Pediatric Blood & Cancer

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The majority of complete responders were patients who had total tumor removal. Treatment failure occurred mainly within the first 2 years, and outcome was dismal for patients who relapsed or had progressive disease. The median age at diagnosis is 6 years in our patient group; younger children (less than 3 years old) have less favorable outcome. There was no significant difference in survival or progression-free survival between the two histologic subtypes.

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Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro‐Oncology Group

Cited by 24 publications

References 0 publications

Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy

Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy

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

Ependymal tumors in childhood

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