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. 2010 Dec 1;78(5):1451-6.
doi: 10.1016/j.ijrobp.2009.09.071. Epub 2010 Mar 24.

Irradiation of pediatric high-grade spinal cord tumors

Rahul D Tendulkar  1 , Atmaram S Pai Panandiker, Shengjie Wu, Larry E Kun, Alberto Broniscer, Robert A Sanford, Thomas E Merchant
Affiliations

Irradiation of pediatric high-grade spinal cord tumors

Rahul D Tendulkar et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To report the outcome using radiation therapy (RT) for pediatric patients with high-grade spinal cord tumors.

Methods and materials: A retrospective chart review was conducted that included 17 children with high-grade spinal cord tumors treated with RT at St. Jude Children's Research Hospital between 1981 and 2007. Three patients had gross total resection, 11 had subtotal resection, and 3 underwent biopsy. The tumor diagnosis was glioblastoma multiforme (n = 7), anaplastic astrocytoma (n = 8), or anaplastic oligodendroglioma (n = 2). Seven patients received craniospinal irradiation (34.2-48.6 Gy). The median dose to the primary site was 52.2 Gy (range, 38-66 Gy).

Results: The median progression-free and overall survivals were 10.8 and 13.8 months, respectively. Local tumor progression at 12 months (79% vs. 30%, p = 0.02) and median survival (13.1 vs. 27.2 months, p = 0.09) were worse for patients with glioblastoma multiforme compared with anaplastic astrocytoma or oligodendroglioma. The median overall survival was shorter for patients when failure included neuraxis dissemination (n = 8) compared with local failure alone (n = 5), 9.6 vs. 13.8 months, p = 0.08. Three long-term survivors with World Health Organization Grade III tumors were alive with follow-up, ranging from 88-239 months.

Conclusions: High-grade spinal cord primary tumors in children have a poor prognosis. The propensity for neuraxis metastases as a component of progression after RT suggests the need for more aggressive therapy.

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Conflict of interest statement

Notification: No actual or potential conflicts of interest exist.

Figures

Figure 1
Figure 1
Progression-free (p = 0.11) and overall survival (p = 0.09) for pediatric patients with high-grade spinal cord tumors by histologic subtype. AA = anaplastic astrocytoma or oligodendroglioma. GBM = glioblastoma multiforme.
Figure 2
Figure 2
Cumulative incidence of local failure (p = 0.02) for pediatric patients with high-grade spinal cord tumors by histologic subtype. AA = anaplastic astrocytoma or oligodendroglioma. GBM = glioblastoma multiforme.
See this image and copyright information in PMC

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