Infant ependymoma in a 10-year AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) experience with omitted or deferred radiotherapy

International Journal of Radiation Oncology, Biology, Physics
Maura MassiminoMaria Luisa Garrè

Abstract

The protocols of the 1990s omitted or delayed irradiation, using upfront chemotherapy to spare the youngest children with ependymoma the sequelae of radiotherapy (RT). We treated 41 children under the age of 3 years with intracranial ependymoma between 1994 and 2003. After surgery, chemotherapy was given as follows: regimen I with four blocks of vincristine, high-dose methotrexate 5 g/m(2), and cyclophosphamide 1.5 g/m(2) alternating with cisplatin 90 mg/m(2) plus VP16 450 mg/m(2) for 14 months; subsequently, regimen II was used: VEC (VCR, VP16 300 mg/m(2), and cyclophosphamide 3 g/m(2)) for 6 months. Radiotherapy was planned for residual tumor after the completion of chemotherapy or for progression. We treated 23 boys and 18 girls who were a median 22 months old; 14 were given regimen I, 27 were given regimen II; 22 underwent complete resection, 19 had residual tumor. Ependymoma was Grade 2 in 25 patients and Grade 3 in 16; tumors were infratentorial in 37 patients and supratentorial in 4. One child had intracranial metastases; 29 had progressed locally after a median 9 months. Event-free survival was 26% at 3 and 5 years and 23% at 8 years. One child died of sepsis, and another developed a glioblastoma 72 months after RT. Pro...Continue Reading

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Citations

Apr 25, 2012·Acta Neuropathologica·Catherine GodfraindDavid W Ellison
Oct 19, 2012·Neuro-oncology·Piergiorgio ModenaMaura Massimino
Sep 10, 2015·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Pietro SpennatoGiuseppe Cinalli
May 21, 2016·Nature Reviews. Neurology·Vinai GondiMinesh P Mehta
Mar 8, 2018·Journal of Neuro-oncology·Brian DeSuzanne L Wolden
Jun 24, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Thomas E Merchant
Jun 16, 2017·PloS One·Felipe AndreiuoloUNKNOWN SIOP Ependymoma Biology Working Group BIOMECA (BIOlogical Markers for Ependymomas in Children and Adolescents)
Nov 1, 2015·Biochemical Society Transactions·Beth CoyleIan D Kerr
Mar 4, 2011·Pediatric Blood & Cancer·Rajkumar VenkatramaniJonathan L Finlay
Jul 18, 2019·Scientific Reports·Durgagauri H SabnisBeth Coyle
Sep 11, 2019·Journal of Neuro-oncology·Lennox ByerSabine Mueller
Dec 17, 2018·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Matthew C H J MorrallRichard Grundy
Jan 29, 2021·International Journal of Radiation Oncology, Biology, Physics·Daniel J IndelicatoShannon M MacDonald

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