Aggressive Therapy Beneficial for Ependymoma Patients

Gross-total resection plus conformal high-dose radiation recommended for young children with ependymoma

TUESDAY, Feb. 3 (HealthDay News) -- Gross-total resection, including second surgery for patients with an incomplete first surgery, plus high-dose postoperative radiotherapy provides long-term benefits in local tumor control, event-free survival and overall survival for children with localized ependymoma, according to research published online Jan. 31 in The Lancet Oncology.

Thomas E. Merchant, of St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues evaluated the efficacy of aggressive surgical intervention plus radiotherapy in children under 3 years of age with localized ependymoma. The investigators treated 153 children with a median age of 2.9 years. After definitive surgery, children received conformal radiotherapy. Patients were then followed for a median of 5.3 years.

During follow-up, 23 children died and 36 patients experienced tumor progression, the researchers report. The seven-year overall survival was 81 percent, and the seven-year rate of event-free survival was 69.1 percent. In patients who received postoperative radiotherapy immediately, without delay or chemotherapy, the rates of overall survival and event-free survival were 85 percent and 76.9 percent, respectively, the investigators found. Tumor grade, extent of resection and demographic factors such as ethnic origin, sex and age were found to affect the survival and tumor outcomes measured, the report indicates.

"Treatment of ependymoma should include surgery with the aim of gross-total resection and conformal, high-dose, postoperative irradiation," the authors conclude. "Future trials might consider treatment stratification based on sex and age."

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