Use of proton therapy for re-irradiation in pediatric intracranial ependymoma. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Eaton, Bree R.; Chowdhry, Varun; Weaver, Kenneth; Liu, Li; Ebb, David; MacDonald, Shannon M.; Tarbell, Nancy J.; Yock, Torunn I.
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 2(2015:Aug.)
• Page Start: 301
• Page End: 308
• Publication Date: 2015-08
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.07.023
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">To report disease control, survival and treatment-associated toxicity with the use of proton therapy (PRT) for re-irradiation of intracranial ependymoma.</p> </sec> <sec> <title id="st015">Materials and methods</title> <p id="sp0010">Twenty patients underwent 33 PRT re-irradiation courses for recurrent or metastatic lesions between June 2004 and February 2015 at Massachusetts General Hospital.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">The majority of patients were female (60%), with infratentorial tumors (90%), anaplastic histology (55%), and initially received 55.8 GyRBE (52.2–59.4) involved field (IF) PRT. First failure was local (55%), distant (30%) or both (15%) at a median time of 23.9 months (9.9–98.5) from first treatment. Salvage therapy included re-resection (75%), chemotherapy (60%) and IFPRT (70%) to a median dose 50.4 GyRBE (35–55.8) in the majority of patients. The median follow-up was 37.8 months (5.5–138.0). Three year OS and PFS are 78.6% (95% CI 67.6–89.6) and 28.1% (95% CI 15.6–40.6), respectively. Longer OS was significantly associated with surgical resection of recurrent disease (HR 9.19, 95% CI 1.27–66.44, <italic>p</italic> = 0.028). The pattern of second failure after re-irradiation was directly related to the pattern of first failure (<italic>p</italic> < 0.01). Three of 14 patients (21.4%) locally re-treated experienced grade 2 radiation-associated treatment change.</p> </sec> <sec> <title id="st025">Conclusions</title> <p id="sp0020">Proton therapy appears safe and efficacious for the re-treatment of recurrent intracranial ependymoma.</p> </sec> </abstract>