paediatrics Brussels 17

Childs Nerv Syst

0.0004): 45% for infratentorial and 20% for supratentorial tumor location.

Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the Children ’ s Cancer Group. J Neurosurg 88:695 – 703 10. Mansur DB, Perry A, Rajaram V, Michalski JM, Park TS, Leonard JR, Luchtman-Jones L, Rich KM, Grigsby PW, Lockett MA, Wahab SH, Simpson JR (2005) Postoperative radiation therapy for grade II and III intracranial ependymoma. Int J Radiat Oncol Biol Phys 61:387 – 391 11. Duffner PK, Horowitz ME, Krischer JP, Friedman HS, Burger PC, Cohen ME, Sanford RA, Mulhern RK, James HE, Freeman CR, Seidel FG, Kun LE (1993) Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumors. N Engl J Med 328:1725 – 1731 12. Strother D, Kepner J, Aronin P, Constine L, Burger P, Langston J, Duffner P, Kun L, Friedman H, Kupst M, Horowitz M (2000) Dose-intensive (DI) chemotherapy (CT) prolongs event-free survival (EFS) for very young children with ependymoma (EP). Results of Pediatric Oncology Group (POG) Study 9233. Proc Am Soc Clin Oncol 19:585a [abstract 2302] http://www.asco.org/ ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview= abst_detail_view&confID=2&abstractID=202687 13. Grill J, Kalifa C, Doz F, Schoepfer C, Sainte-Rose C, Couanet D, Terrier-Lacombe MJ, Valteau-Couanet D, Hartmann O (1996) A high-dose busulfan – thiotepa combination followed by autologous bone marrow transplantation in childhood recurrent ependymoma. A phase-II study. Pediatr Neurosurg 25:7 – 12 14. Grundy RG, Wilne SA, Weston CL, Robinson K, Lashford LS, Ironside J, Cox T, Chong WK, Campbell RH, Bailey CC, Gattamaneni R, Picton S, Thorpe N, Mallucci C, English MW, Punt JA, Walker DA, Ellison DW, Machin D, Children ’ s Cancer and Leukaemia Group (formerly UKCCSG) Brain Tumour Committee (2007) Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children: the UKCCSG/SIOP prospective study. Lancet Oncol 8:696 – 705 15. Evans AE, Anderson JR, Lefkowitz-Boudreaux IB, Finlay JL (1996) Adjuvant chemotherapy of childhood posterior fossa ependymoma: cranio-spinal irradiation with or without adjuvant CCNU, vincristine, and prednisone: a Childrens Cancer Group study. Med Pediatr Oncol 27:8 – 14 16. Vanuytsel L, Brada M (1991) The role of prophylactic spinal irradiation in localized intracranial ependymoma. Int J Radiat Oncol Biol Phys 21(3):825 – 830 17. Merchant TE, Mulhern RK, Krasin MJ, Kun LE, Williams T, Li C, Xiong X, Khan RB, Lustig RH, Boop FA, Sanford RA (2004) Preliminary results from a phase II trial of conformal radiation therapy and evaluation of radiation-related CNS effects for pediatric patients with localized ependymoma. J Clin Oncol 22:3156 – 3162 18. Merchant TE, Kiehna EN, Li C, Xiong X, Mulhern RK (2005) Radiation dosimetry predicts IQ after conformal radiation therapy in pediatric patients with localized ependymoma. Int J Radiat Oncol Biol Phys 63(5):1546 – 1554 19. National Cancer Institute, U.S. National Institutes of Health: phase II study of reduced-field conformal radiotherapy in young patients with low-grade gliomas. http://www.cancer.gov/clinicaltrials/ COG-ACNS0221 20. Merchant TE, Li C, Xiong X, Kun LE, Boop FA, Sanford RA (2009) Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. Lancet Oncol 10(3):258 – 266 21. International Commission on Radiological Units (ICRU) Report 50 (1993) Prescribing, recording, and reporting beam therapy. ICRU, Washington, DC 22. International Commission on Radiological Units (ICRU) Report 62 (1999) Prescribing, recording and reporting photon beam therapy (supplement to ICRU Report 50). ICRU, Washington, DC

Conclusion

The advent of conformal radiation therapy has provided a renewed interest in radiation therapy for the frontline management of ependymoma, especially for younger patients. Selected contemporary series report high rates of tumor control and overall survival (Table 3 ) for favorable patients now confirmed with longer-term data. These data provide a basis for future studies that will attempt to improve upon the results achieved with modern surgery and radiation therapy using additional forms of adjuvant and possibly systemic therapy. Acknowledgments This work was supported in part by American Cancer Society and by the American Lebanese Syrian Associated Charities (ALSAC). 1. Central Brain Tumor Registry of the United States (2002) CBTRUS 2002: statistical report: primary brain tumors in the United States, 1995 – 1999. Central Brain Tumor Registry of the United States, Hinsdale, IL 2. Akyüz C, Emir S, Akalan N, Söylemezo ğ lu F, Kutluk T, Büyükpamukçu M (2000) Intracranial ependymomas in child- hood — a retrospective review of sixty-two children. Acta Oncol 39:97 – 100 3. Perilongo G, Massimino M, Sotti G, Belfontali T, Masiero L, Rigobello L, Garrè L, Carli M, Lombardi F, Solero C, Sainati L, Canale V, del Prever AB, Giangaspero F, Andreussi L, Mazza C, Madon E (1997) Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro- oncology Group. Med Pediatr Oncol 29:79 – 85 4. Shu HK, Sall WF, Maity A, Tochner ZA, Janss AJ, Belasco JB, Rorke-Adams LB, Phillips PC, Sutton LN, Fisher MJ (2007) Childhood intracranial ependymoma: twenty-year experience from a single institution. Cancer 110:432 – 441 5. Oya N, Shibamoto Y, Nagata Y, Negoro Y, Hiraoka M (2002) Postoperative radiotherapy for intracranial ependymoma: analysis of prognostic factors and patterns of failure. J Neurooncol 56:87 – 94 6. Pollack IF, Gerszten PC, Martinez AJ, Lo KH, Shultz B, Albright AL, Janosky J, Deutsch M (1995) Intracranial ependymomas of childhood: long-term outcome and prognostic factors. Neurosur- gery 37:655 – 666 discussion 666 – 667 7. Jaing TH, Wang HS, Tsay PK, Tseng CK, Jung SM, Lin KL, Lui TN (2004) Multivariate analysis of clinical prognostic factors in children with intracranial ependymomas. J Neurooncol 68:255 – 261 8. van Veelen-Vincent ML, Pierre-Kahn A, Kalifa C, Sainte-Rose C, Zerah M, Thorne J, Renier D (2002) Ependymoma in childhood: prognostic factors, extent of surgery, and adjuvant therapy. J Neurosurg 97:827 – 835 9. Robertson PL, Zeltzer PM, Boyett JM, Rorke LB, Allen JC, Geyer JR, Stanley P, Li H, Albright AL, McGuire-Cullen P, Finlay JL, Stevens KR Jr, Milstein JM, Packer RJ, Wisoff J (1998) References