0.0004): 45% for infratentorial and 20% for supratentorial
tumor location.
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).
References
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)
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=20268713. 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-ACNS022120. 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
Childs Nerv Syst