Spinal cord gliomas: A multi-institutional retrospective analysis.
OBJECTIVE
To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas.


METHODS
Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed.


RESULTS
A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01).


CONCLUSIONS
Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS.
Abdel-Wahab
May
M
Department of Radiation Oncology, University of Miami, Miami, FL, USA. mwahab@med.miami.edu
Etuk
Blessing
B
Palermo
James
J
Shirato
Hiroki
H
Kresl
John
J
Yapicier
Ozlem
O
Walker
Gail
G
Scheithauer
Bernd W
BW
Shaw
Edward
E
Lee
Charles
C
Curran
Walter
W
Thomas
Terry
T
Markoe
Arnold
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004806:Ependymoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005910:Glioma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis