Patterns of failure after radiotherapy for pediatric patients with intracranial ependymoma

Tensaouti, F.; Ducassou, A.; Chaltiel, Léonor; Bolle, Stéphanie; Muracciole, Xavier; Coche‐Dequeant, B.; Alapetite, Claire; Bernier, V.; Claude, L.; Supiot, S.; Huchet, A.; Kerr, Christine; Prisé, É. Le; Laprie, Anne

doi:10.1016/j.radonc.2016.12.025

Cited by 18 publications

(17 citation statements)

References 32 publications

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“…Surgery and radiotherapy are the cornerstones of care for EPN in children . GTR and adjuvant radiation significantly improved the survival of pediatric patients with intracranial grade II/III EPN in our study.…”

Section: Discussionsupporting

confidence: 51%

Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma

et al. 2019

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Background: Models for estimation of survival rates of patients with intracranial grade II/III ependymoma (EPN) are scarce. Considering the heterogeneity in prognostic factors between pediatric and adult patients, we aimed to develop age-specific nomograms for predicting 3-, 5-, and 8-year survival for these patients. Methods: A total of 1390 cases (667 children; 723 adults) of intracranial grade II/ III EPNs diagnosed between 1988 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for our study. Univariable and multivariable Cox analyses were employed to identify independent prognostic predictors. Age-specific nomograms were developed based on the results of multivariate Cox analyses. We also evaluated the performance of these predictive models by concordance index, calibration curves, time-dependent receiver operating characteristic curves, and decision curve analyses. Results: Considerable heterogeneity in prognostic factors was highlighted between pediatric and adult patients. Age, sex, tumor grade, surgery treatment and radiotherapy were identified as significant predictors of overall survival for children, and age, tumor grade, tumor size, surgery treatment, and marital status for adult. Based on these factors, age-specific nomogram models were established and internally validated. These models exhibited favorable discrimination and calibration characteristics. Nomogram-based risk classification systems were also constructed to facilitate risk stratification in EPNs for optimization of clinical management. Conclusions:We developed the first nomograms and corresponding risk classification systems for predicting survival in patients with intracranial grade II/III EPN.These easily used tools can assist oncologists in making accurate survival evaluation. K E Y W O R D Sgrade II/III ependymoma, intracranial, nomogram, overall survival, SEER 616 | DENG Et al.

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Section: Discussionsupporting

confidence: 51%

Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma

et al. 2019

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“…Serious toxicity was limited and no unexpected side effects were observed. Specifically, the rates of symptomatic brainstem necrosis and vasculopathy in this cohort were comparable to reports of children treated with photons over the past 5 years …”

Section: Discussionsupporting

confidence: 72%

Clinical outcomes following proton therapy for children with central nervous system tumors referred overseas

Indelicato

Bradley

Sandler

et al. 2017

Pediatric Blood & Cancer

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Background International, multidisciplinary care of children with central nervous system (CNS) tumors presents unique challenges. The aim of this study is to report patient outcomes of U.K. children referred for proton therapy to a North American facility. Methods From 2008 to 2016, 166 U.K. children with approved CNS tumors were treated with proton therapy at a single academic medical center in the United States. Median age was 7 years (range, 1–19). Median follow‐up was 2.6 years. Results The 3‐year actuarial overall survival (OS) and local control (LC) rates were 96% and 91%, respectively, for the overall group, 92% and 85% for the ependymoma subgroup (n = 57), 95% and 88% for the low‐grade glioma subgroup (n = 54), and 100% and 100%, respectively, for the craniopharyngioma subgroup (n = 45). Cyst expansion was observed in 13 patients, including one case resulting in visual impairment. Serious side effects included new‐onset seizures in three patients (1.8%), symptomatic vasculopathy in three patients (1.8%), and symptomatic brainstem necrosis in one patient (0.6%). Conclusions In this cohort of British children referred overseas for proton therapy, disease control does not appear compromised, toxicity is acceptable, and improvement in long‐term function is anticipated in survivors owing to the reduced brain exposure afforded by proton therapy.

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“…We found no recurrence of the primary brain tumor, either local or distant, 10 years or more after the end of treatment in the reviewed literature . After combining the latency period from all relapses, median time to relapse was 13.7 months; average minimal latency time was 3.3 months and a maximum of 49.0 months.…”

Section: Discussionmentioning

confidence: 79%

“…Thirty to 54% of patients relapsed between 1 month and 8.6 years from diagnosis, with a mean of 12‐19 months . No data concerning symptomatic or asymptomatic recurrence are available.…”

Section: Resultsmentioning

confidence: 99%

Surveillance imaging for high‐grade childhood brain tumors: What to do 10 years after completion of treatment?

Otth

Scheinemann

2018

Pediatric Blood & Cancer

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Brain tumors are the second most common childhood cancer. Treatment protocols for high-grade pediatric brain tumors recommend regular follow-up imaging for up to 10 years. We review maximal time to recurrence and minimal time to radiologically detectable long-term sequelae such as secondary malignancies, vascular complications, and white matter disease. No tumors recurred after the 10-year point, but radiological long-term sequelae grew more common as the treatment completion date receded. We do not recommend regular imaging more than 10 years after treatment has ended, unless there are clinical symptoms.

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Patterns of failure after radiotherapy for pediatric patients with intracranial ependymoma

Cited by 18 publications

References 32 publications

Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma

Personalizing age‐specific survival prediction and risk stratification in intracranial grade II/III ependymoma

Clinical outcomes following proton therapy for children with central nervous system tumors referred overseas

Surveillance imaging for high‐grade childhood brain tumors: What to do 10 years after completion of treatment?

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