An Overview of the Management of Adult Ependymomas with Emphasis on Relapsed Disease

Iqbal, Muhammad Shahid; Lewis, Joanne

doi:10.1016/j.clon.2013.07.009

Cited by 26 publications

(15 citation statements)

References 45 publications

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“…As such, subtotally resected and high-grade cases typically receive adjuvant treatments, such as radiation and chemotherapy. 11,16,27 Stereotactic radiosurgery is a therapeutic option for intracranial ependymomas and has been shown to be effective in achieving palliative control in recurrent cases. 15,19,32 Chemotherapy, although usually employed as a salvage option, has not been shown to provide consistent long-term control of these tumors.…”

Section: Discussionmentioning

confidence: 99%

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Patel

Jethwa

Shetty

et al. 2015

PED

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OBJECT Although control of intracranial ependymomas is highly correlated with degree of resection, it is unknown if the same is true for MRI-guided laser-induced thermal therapy (MRgLITT). The authors report their experience with MRgLITT for ependymoma and examine the utility of the real-time thermal damage estimate (TDE), a recent software advance, with respect to completeness of ablation and impact on tumor control. To the authors' knowledge, this is the largest single-center experience utilizing MRgLITT for recurrent ependymomas. METHODS Five tumors in 4 patients were treated with the Visualase Thermal Therapy System. Two tumors were treated similarly on recurrence. Ablation was performed using a 980-nm diode laser with a real-time image acquisition system. Single-plane TDEs were calculated and compared with the original lesion area to compute percentage area ablated (PAA). Volumetric analysis was performed, and percentage volume ablated (PVA) was estimated and correlated with the TDE. Tumor control was correlated with the TDE and volumetric data during treatment. RESULTS Nine ablations were performed on 5 tumors, 2 of which had multiple recurrences. The average pretreatment lesion volume was 8.4 ± 6.3 cm3, and the average largest 2D area was 5.3 ± 2.7 cm2. The averaged TDE was 3.9 ± 2.1 cm2, average PAA was 80.1% ± 34.3%, and average PVA was 64.4% ± 23.5%. For subtotal ablations, average recurrence time was 4.4 ± 5.3 months; 1 adult case remains recurrence-free at 40 months. Using TDEs, the correlation between recurrence time and PAA was r = 0.93 (p = 0.01), and for PVA was r = 0.88 (p = 0.02). Furthermore, PVA and PAA were strongly correlated (r = 0.88, p = 0.02). CONCLUSIONS Through using the PAA, the real-time TDE correlated with the volume of ablation in this initial investigation. Furthermore, the TDE and volumetric data corresponded to the level of tumor control, with time to recurrence dependent on ablation completeness. MRgLITT may have a role in the management of recurrent ependymomas, especially with recent software advances.

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Section: Discussionmentioning

confidence: 99%

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Patel

Jethwa

Shetty

et al. 2015

PED

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“…As with other CNS tumors, the extent of surgical resection affects the prognosis and provides essential diagnostic information . Additional treatment generally consists of radiation or a combination of radiation and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…As with other CNS tumors, the extent of surgical resection affects the prognosis and provides essential diagnostic information. 6 Additional treatment generally consists of radiation or a combination of radiation and chemotherapy. Although there have been seminal molecular discoveries in ependymoma research, prospective clinical trials exploring the efficacy of treatment regimens are uncommon or are often limited to single-institution accrual or retrospective reviews.…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation and outcomes for adult ependymoma patients

Acquaye

Vera

Gilbert

et al. 2016

Cancer

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“…Maximal surgical resection may be beneficial when weighed against risks and baseline patient condition. 29 …”

Section: Intracranial Ependymomasmentioning

confidence: 99%

Case-based review: ependymomas in adults

Cachia

Johnson

Kaufmann

et al. 2018

Neuro-Oncology Practice

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Ependymomas are rare primary central nervous system (CNS) tumors in adults. They occur most commonly in the spinal cord, and have classically been graded histologically into World Health Organization (WHO) grades I, II, or III based on the level of anaplasia. Recent data are showing that genetic heterogeneity occurs within the same histological subgroup and that ependymomas arising from different CNS locations have different molecular signatures. This has renewed interest in developing targeting therapies based on molecular profiles especially given the variable outcomes with radiation and the poor results with cytotoxic agents. In this paper, we present the case of a 46-year-old woman with a classic presentation of spinal cord ependymoma and discuss the current histopathological and molecular classification for ependymomas as well as current guidelines for patient management.

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An Overview of the Management of Adult Ependymomas with Emphasis on Relapsed Disease

Cited by 26 publications

References 45 publications

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Does the real-time thermal damage estimate allow for estimation of tumor control after MRI-guided laser-induced thermal therapy? Initial experience with recurrent intracranial ependymomas

Clinical presentation and outcomes for adult ependymoma patients

Case-based review: ependymomas in adults

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