The role of adjuvant radiation therapy in the treatment of spinal myxopapillary ependymomas Clinical article

Object The goal in this study was to determine the role of radiation therapy (RT) in the treatment of spinal myxopapillary ependymomas (MPEs) Methods Thirty-seven patients with histologically verified spinal MPEs were reviewed Kaplan-Meier analyses and Cox proportional hazard regression were used to determine what patient and treatment factors influenced overall survival (OS) and recurrence Results At the time of initial diagnosis the median age was 33 years and the Karnofsky Performance Scale score was 80 In 86 5% of cases the most common presenting symptom was pain All patients received surgery as their initial treatment Nine patients also received RI along with surgery, with a median total dose of 50 2 Gy The mean survival time was 12 2 years however only 4 of 37 patients had died at the time of this study None of the patient or treatment parameters significantly correlated with OS Sixteen patients (43 2%) were found to have a recurrence with a median time to recurrence of 7 7 years None of the patient or treatment parameters correlated with recurrence-free survival for an initial recurrence The median time to the second recurrence (recurrence following therapy for initial recurrence) was 1 6 years Use of RT as salvage therapy after initial recurrence significantly correlated with longer times to a second recurrence The median recurrence-free survival time before the second recurrence was 9 6 years for those who received RT versus 1 1 years for those who did not receive RT (p = 0 0093) None of the other parameters significantly correlated with a second recurrence Conclusions Radiation therapy may have a role as salvage therapy in delaying recurrences of spinal MPEs (DOI 10 3171/2010 9 SPINE09920)