Re-irradiation of locally recurrent pediatric intracranial ependymoma: Experience of the French society of children's cancer. (March 2019)

• Record Type: Journal Article
• Authors: Régnier, Elise; Laprie, Anne; Ducassou, Anne; Bolle, Stéphanie; Supiot, Stéphane; Muracciole, Xavier; Claude, Line; Chapet, Sophie; Coche-Dequéant, Bernard; Vigneron, Céline; Leseur, Julie; Bondiau, Pierre Y.; Habrand, Jean L.; Bernier, Valérie
• Is Part Of: Radiotherapy and oncology. Volume 132(2019)
• Page Start: 1
• Page End: 7
• Publication Date: 2019-03
• Subjects: Radiotherapy -- Reirradiation -- Pediatric -- Ependymoma -- Brain -- Recurrence; 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.2018.11.009
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Purpose: This study aimed to evaluate retrospectively the clinical results of re-irradiation for children with a locally recurrent brain ependymoma. Methods: 33 full-dose re-irradiations were delivered to 31 children with a recurrent brain ependymoma after a standard treatment. Each child was followed up with clinical and MRI examinations. We evaluated overall survival, local recurrence free-survival and short term toxicity according to CTCAE 4.0 scale. Results: With a median follow-up of 37 months (range, 0 to 107), median local recurrence free-survival was 31 months (range, 2 to 63) and median overall survival was 34 months (range, 3 to 63). It was significantly higher in patients who underwent surgery first, compared with re-irradiation only. Cumulated dosimetric data were available for 22 patients. On average, maximal BED to brain stem was 106, 2 Gyα/β3 (±35, 4) for infratentorial re-irradiation. No acute toxicity grade >2 was reported and 1 case of brain radionecrosis treated successfully with steroids was reported after radiosurgery. Conclusion: Local recurrence of brain ependymoma can be treated with full-dose re-irradiation, which can be hypofractionated with an acceptable short term toxicity in spite of high total doses delivered to OARs, especially brain stem.