Recurrent spinal ependymoma showing partial remission under Imatimib

Fakhrai, Negar; Neophytou, P.; Dieckmann, Karin; Nemeth, Alexandra; Prayer, Daniela; Hainfellner, J.; Marosi, Christine

doi:10.1007/s00701-004-0374-5

Cited by 50 publications

(28 citation statements)

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“…A variety of agents have been tried, including chronic oral etoposide, with modest success [61]. An intriguing article reported on a minor response using imatinib in a spinal ependymoma that expressed the PDGF receptors [62].…”

Section: Spinal Cord Ependymomasmentioning

confidence: 99%

Ependymomas in Adults

Gilbert

Rudà

Soffietti

2010

Curr Neurol Neurosci Rep

140

119

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Ependymomas are rare primary central nervous system tumors in adults. They occur most commonly in the spinal cord, where histopathologic evaluation is critical to differentiate the grade I myxopapillary ependymoma from the grade II ependymoma or grade III anaplastic ependymoma. Brain ependymomas are either grade II or III. Treatment for all grades and types includes maximum surgical resection. For myxopapillary ependymoma, complete removal while maintaining capsule integrity may be curative. Some grade II ependymomas may be observed carefully after imaging confirms complete resection, but grade III tumors require adjuvant radiation treatment. Radiation commonly is given to the region of tumor, except in cases in which there is imaging or cerebrospinal fluid evidence of tumor dissemination. Chemotherapy has not been studied extensively, although most reports suggest only modest benefit. Ongoing laboratory studies have uncovered important signal transduction pathways that may be better therapeutic targets, leading to the development of clinical trials using targeted agents.

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Section: Spinal Cord Ependymomasmentioning

confidence: 99%

Ependymomas in Adults

Gilbert

Rudà

Soffietti

2010

Curr Neurol Neurosci Rep

140

119

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“…Two patients demonstrated partial responses following treatment with chronic oral etoposide, while another 5 patients maintained stable disease. Fakhrai et al 38 reported clinical improvement and mild tumor regression in a patient with a platelet-derived growth factor receptor-positive spinal ependymoma treated with imatinib. Iunes and colleagues 61 discussed a patient receiving postoperative carboplatin and radiotherapy for their intradural extramedullary tumor with multifocal presentation; the patient survived 2 years.…”

Section: Chemotherapymentioning

confidence: 99%

Complications associated with the treatment for spinal ependymomas

Nagasawa

Smith

Cremer

et al. 2011

FOC

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Spinal cord ependymomas are rare neoplasms, comprising approximately 5% of all CNS tumors and 15% of all spinal cord tumors. Although surgery was once reserved for diagnosis alone, the evolution of surgical practices has elevated resection to the treatment of choice for these lesions. While technological advances continue to improve the capacity for gross-total resections and thus decrease the risk of recurrence, ependymoma spinal surgery still contains a variety of potential complications. The presence of neurological deficits and deterioration are not uncommonly associated with spinal cord ependymoma surgery, including sensory loss, dorsal column dysfunction, dysesthetic syndrome, and bowel and bladder dysfunction, particularly in the immediate postoperative period. Surgical treatment may also lead to wound complications and CSF leaks, with increased risk when radiotherapy has been involved. Radiation therapy may also predispose patients to radiation myelopathy and ultimately result in neurological damage. Additionally, resections of spinal ependymomas have been associated with postoperative spinal instability and deformities, particularly in the pediatric population. Despite the advances in microsurgical techniques and intraoperative cord monitoring modalities, there remain a number of serious complications related to the treatment of spinal ependymoma tumors. Identification and acknowledgment of these potential problems may assist in their prevention, early detection, and increased quality of life for patients afflicted with this disease.

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“…Так, N. Fakharai и соавт. [11] опубликовали кли-нический случай применения иматимаба у пациент-ки с продолженным ростом опухоли конского хво-ста (эпендимома Grade II), которая наблюдалась в течение 11 мес. Был отмечен регресс неврологиче-ской симптоматики и положительная динамика на МРТ в виде уменьшения объема опухоли.…”

Section: Discussionunclassified