PROGNOSTIC FACTORS IN CHILDHOOD EPENDYMOMAS

被引:109
|
作者
SUTTON, LN
GOLDWEIN, J
PERILONGO, G
LANG, B
SCHUT, L
RORKE, L
PACKER, R
机构
[1] Neuro-oncology program, Children’s Hospital of Philadelphia, PA
关键词
EPENDYMOMA; CHEMOTHERAPY; CISPLATINUM; CHILDREN;
D O I
10.1159/000120509
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Between 1975 and 1989, 45 children with newly diagnosed intracranial ependymomas were treated at the authors' institution. Patients were managed with aggressive surgical resection, followed by postoperative CT or MRI scans to evaluate the extent of resection. Most patients received involved-field radiation therapy, however 10 were treated with craniospinal axis irradiation for disseminated disease, or malignant histology. Beginning in 1983, all patients were also treated with adjuvant chemotherapy with [-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), vincristine, and cisplatinum. Four patients died in the immediate postoperative period for an operative mortality of 8.8%. The 5-year progression-free survival for the remaining 41 patients was 36%. Tumor location had little effect on survival, as the 5-year PFS for supratentorial tumors was 26%, compared with 40% for the posterior fossa lesions (ns). Neither histologic decree of malignancy. nor use of adjuvant chemotherapy impacted on survival. The extent of surgical resection, as determined by operative reports and postoperative imaging studies, was a major determinant of out-come, as patients with total or near-total resections experienced a 5-year PFS of 60%, compared with 21% for children with partial resection or biopsy (p < 0.01). It is concluded that the use of adjuvant chemotherapy with CCNU, vincristine, and cisplatinum does not improve progression-free survival in childhood ependymoma. and that the extent of surgical resection is a major determinant of outcome in this disease.
引用
收藏
页码:57 / 65
页数:9
相关论文
共 50 条
  • [1] INFRATENTORIAL EPENDYMOMAS IN CHILDHOOD - PROGNOSTIC FACTORS AND TREATMENT
    NAZAR, GB
    HOFFMAN, HJ
    BECKER, LE
    JENKIN, D
    HUMPHREYS, RP
    HENDRICK, EB
    JOURNAL OF NEUROSURGERY, 1990, 72 (03) : 408 - 417
  • [2] INTRACRANIAL EPENDYMOMAS OF CHILDHOOD - LONG-TERM OUTCOME AND PROGNOSTIC FACTORS
    POLLACK, IF
    GERSZTEN, PC
    MARTINEZ, AJ
    LO, KH
    SHULTZ, B
    ALBRIGHT, AL
    JANOSKY, J
    DEUTSCH, M
    NEUROSURGERY, 1995, 37 (04) : 655 - 666
  • [3] Prognostic factors in childhood intracranial ependymomas: The role of age and tumor location
    Sala, F
    Talacchi, A
    Mazza, C
    Prisco, R
    Ghimenton, C
    Bricolo, A
    PEDIATRIC NEUROSURGERY, 1998, 28 (03) : 135 - 142
  • [4] INTRACRANIAL EPENDYMOMAS OF CHILDHOOD - LONG-TERM OUTCOME AND PROGNOSTIC FACTORS
    POLLACK, IF
    GERSZTEN, P
    MARTINEZ, AJ
    JOURNAL OF NEUROSURGERY, 1995, 82 (02) : A351 - A352
  • [5] Prognostic Factors in Supratentorial Ependymomas
    Alexiou, George A.
    Stefanaki, Kalliopi
    Prodromou, Neofytos
    PEDIATRIC NEUROSURGERY, 2013, 49 (02) : 129 - 129
  • [6] PROGNOSTIC FACTORS IN INFANTS WITH EPENDYMOMAS
    DUFFNER, PK
    COHEN, ME
    KUN, L
    KRISCHER, J
    SANFORD, R
    BURGER, P
    HOROWITZ, M
    FRIEDMAN, H
    ANNALS OF NEUROLOGY, 1995, 38 (03) : 546 - 546
  • [8] Prognostic factors in intracranial ependymomas in children
    Figarella-Branger, D
    Civatte, M
    Bouvier-Labit, C
    Gouvernet, J
    Gambarelli, D
    Gentet, JC
    Lena, G
    Choux, M
    Pellissier, JF
    JOURNAL OF NEUROSURGERY, 2000, 93 (04) : 605 - 613
  • [9] Prognostic Factors in Supratentorial Ependymomas Reply
    Tanaka, Toshihide
    PEDIATRIC NEUROSURGERY, 2013, 49 (02) : 130 - 130
  • [10] PROGNOSTIC FACTORS AND MANAGEMENT OF INTRACRANIAL EPENDYMOMAS
    PAPADOPOULOS, DP
    GIRI, S
    EVANS, RG
    ANTICANCER RESEARCH, 1990, 10 (03) : 689 - 692