title: [Prognostic factors and results after the combined surgical and radiotherapy treatment of ependymomas].
abstract: Between 1978 and 1991, 31 patients with primary (n = 28) and recurrent (n = 3) ependymoma received external radiation after initial surgery. There were 26 cases of intracranial and five cases of spinal ependymoma. Histological grading revealed low-grade in 23 and high-grade tumors in eight patients. Craniospinal irradiation was given to 13 of 28 patients, whole cranial radiation with boost to posterior fossa in three and local treatment to twelve patients. Six of 28 patients received chemotherapy. Dose to the primary, tumor localisation, grading and extend of surgery did not significantly impact on survival and relapse-free survival. Age was a marginally significant prognostic factor for survival. In patients with intracranial ependymoma (n = 24) survival and relapse-free survival at five years were 54% and 42%, respectively. Patterns of recurrence showed a local recurrence alone in eight, a CNS-relapse with local recurrence in four and local recurrence with distant metastases in one case. Spinal seeding occurred in two of 13 after craniospinal irradiation and two of twelve patients after local treatment. The main problem in the treatment of ependymoma remains local control, the use of spinal irradiation does not seem to improve treatment results.
authors: Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.
authors: G G
authors: GG
authors: Grabenbauer
authors: B
authors: B
authors: Barta
authors: J
authors: J
authors: Erhardt
authors: M
authors: M
authors: Buchfelder
authors: P
authors: P
authors: Thierauf
authors: J D
authors: JD
authors: Beck
authors: R
authors: R
authors: Sauer
mesh_terms: D000293:Adolescent; D000328:Adult; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004806:Ependymoma / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015192:Infratentorial Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011182:Postoperative Care; D011379:Prognosis; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000628:therapy*; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000628:therapy*
vernacular_title: Prognostische Faktoren und Ergebnisse nach kombiniert operativer und strahlentherapeutischer Behandlung des Ependymoms.