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. 2017 Oct-Dec;38(4):420-426.
doi: 10.4103/ijmpo.ijmpo_202_15.

Prognostic Factors and Survival Outcomes of Intracranial Ependymoma Treated with Multimodality Approach

Kunhi Parambath Haresh  1 , Ajeet Kumar Gandhi  2 , Supriya Mallick  1 , Rony Benson  1 , Subhash Gupta  1 , Daya Nand Sharma  1 , Pramod Kumar Julka  1 , Goura Kisor Rath  3
Affiliations

Prognostic Factors and Survival Outcomes of Intracranial Ependymoma Treated with Multimodality Approach

Kunhi Parambath Haresh et al. Indian J Med Paediatr Oncol. 2017 Oct-Dec.

Abstract

Objectives: We aimed to analyze treatment outcomes of intracranial ependymoma (ICE) treated at our institute with multimodality approach.

Materials and methods: Demography, treatment details, and survival data of 40 patients (2005-2012) were collected in a predesigned pro forma. Kaplan Meier method was used to analyze disease-free survival (DFS) and the impact of prognostic factors was determined using univariate analysis (log-rank test). Multivariate analysis was performed using Cox-proportional hazard model. SPSS version 21.0 was used for all statistical analysis.

Results: Male:female ratio was 29:11. Gross total resection: subtotal resection or less was 42.5%: 57.5%. A total of 16 patients (40%) had anaplastic histology. All except two patients received adjuvant radiotherapy. Four patients received concurrent chemotherapy (temozolomide [TMZ]) and 10 patients received adjuvant chemotherapy (6 carboplatin plus etoposide; 4 TMZ). Median follows up was 18 months (2-60 months). Median DFS for the entire cohort was 22.42 months. The estimated 1, 2, and 3 years DFS was found to be 58.5%, 41%, and 30.7%, respectively. On univariate analysis, patients receiving higher radiation dose (56 Gray vs. 60 Gray; hazard ratio [HR] 0.366; 95% confidence interval [CI] 0.142-0.9553; P = 0.02) and lower MIB labeling index (<20 vs. ≥20; HR 0.238; 95% CI 0.092-0.617; P = 0.001) had a better DFS. Higher radiation dose continued to be an independent prognostic factor on multivariate analysis (HR 0.212; 95% CI 0.064-0.856; P = 0.03).

Conclusion: ICE has guarded prognosis. Adjuvant radiotherapy to a higher radiation dose improves survival. Higher MIB labeling index connotes a dismal survival despite the use of radiotherapy and chemotherapy.

Keywords: Chemotherapy; ependymoma; intracranial; radiation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan Meier estimates of disease free survival of the entire cohort
Figure 2
Figure 2
Impact of radiation dose on disease free survival
Figure 3
Figure 3
Impact of MIB labelling index on disease free survival
See this image and copyright information in PMC

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References

    1. Gondi V, Vogelbaum MA, Grimm S, Mehta MP. Primary intracranial neoplasm. In: Halperin EC, Wazer DE, Perez CA, Brady LW, editors. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. pp. 669–70.
    1. Freeman CR, Farmer JP, Taylor RE. Central Nervous System Tumors in Children. In: Halperin EC, Wazer DE, Perez CA, Brady LW, editors. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. pp. 1643–5.
    1. Salazar OM, Castro-Vita H, VanHoutte P, Rubin P, Aygun C. Improved survival in cases of intracranial ependymoma after radiation therapy. Late report and recommendations. J Neurosurg. 1983;59:652–9. - PubMed
    1. Goldwein JW, Corn BW, Finlay JL, Packer RJ, Rorke LB, Schut L. Is craniospinal irradiation required to cure children with malignant (anaplastic) intracranial ependymomas? Cancer. 1991;67:2766–71. - PubMed
    1. Paulino AC. The local field in infratentorial ependymoma: Does the entire posterior fossa need to be treated? Int J Radiat Oncol Biol Phys. 2001;49:757–61. - PubMed