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. 2016 Apr 23:16:287.
doi: 10.1186/s12885-016-2323-0.

Chemotherapy for intracranial ependymoma in adults

Dorothee Gramatzki  1 , Patrick Roth  2 , Jörg Felsberg  3   4 , Silvia Hofer  5 , Elisabeth J Rushing  6 , Bettina Hentschel  7 , Manfred Westphal  8 , Dietmar Krex  9 , Matthias Simon  10 , Oliver Schnell  11 , Wolfgang Wick  12   13 , Guido Reifenberger  4   13 , Michael Weller  2   13
Affiliations

Chemotherapy for intracranial ependymoma in adults

Dorothee Gramatzki et al. BMC Cancer. .

Abstract

Background: Ependymal tumors in adults are rare, accounting for less than 4% of primary tumors of the central nervous system in this age group. The low prevalence of intracranial ependymoma in adults limits the ability to perform clinical trials. Therefore, treatment decisions are based on small, mostly retrospective studies and the role of chemotherapy has remained unclear.

Methods: We performed a retrospective study on 17 adult patients diagnosed with intracranial World Health Organisation grade II or III ependymoma, who were treated with chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by applying Macdonald criteria. Progression-free (PFS) and overall survival (OS) were calculated from start of chemotherapy, using the Kaplan-Meier method.

Results: Eleven patients had supratentorial and 6 infratentorial tumors. Ten patients were treated with temozolomide (TMZ), 3 with procarbazine/lomustine/vincristine (PCV), 3 with platinum-based chemotherapy and 1 patient received epirubicin/ifosfamide. Response rates were as follows: TMZ 8/10 stable disease; PCV 3/3 stable disease; platinum-based chemotherapy 1/3 partial response; epirubicin/ifosfamide 1/1 complete response. PFS rates at 6, 12 and 24 months were 52.9, 35.3 and 23.5%. OS rates at 6, 12 and 24 months were 82.4, 82.4 and 70.1%. There was no indication for a favourable prognostic role of O(6)-methylguanyl-DNA-methyltransferase (MGMT) promoter methylation which was detected in 3/12 investigated tumors.

Conclusions: Survival outcomes in response to chemotherapy in adult intracranial ependymoma patients vary substantially, but individual patients may respond to any kind of chemotherapy. There were too few patients to compare survival data between chemotherapeutic subgroups.

Keywords: Adults; Chemotherapy; Intracranial ependymoma; Overall survival; Progression-free survival.

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Figures

Fig. 1
Fig. 1
Outcome in ependymoma patients. Kaplan-Meier survival curves of PFS (a) and OS (b) after chemotherapy are shown for all 17 patients, initially diagnosed with ependymoma (black line) or for the 15 patients, diagnosed with ependymoma at time of start CT (grey line); the two patients excluded for the second analysis were initially diagnosed with ependymoma, but diagnosed with sarcoma or gliosarcoma at time of recurrence
See this image and copyright information in PMC

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