The impact of radiotherapy fields in the treatment of patients with choroid plexus carcinoma.
OBJECTIVE
To perform a comprehensive literature review and analysis of cases dealing with choroid plexus carcinoma (CPC) to determine the optimal radiotherapy (RT) treatment field.


METHODS
A PubMed search of English language articles from 1979 to 2008 was performed, yielding 33 articles with 56 patients who had available data regarding RT treatment field. The median age at diagnosis was 2.7 years (range, 1 month-53 years). Of 54 patients with data regarding type of surgery, 21 (38.9%) had complete resection. Chemotherapy was delivered to 27 (48%) as part of initial therapy. The RT treatment volume was the craniospinal axis in 38 (68%), whole brain in 9 (16%), and tumor/tumor bed in 9 (16%). Median follow-up for surviving patients was 40 months.


RESULTS
The 5-year overall survival and progression-free survival (PFS) rates were 59.5% and 37.2%, respectively. Complete resection (p = 0.035) and use of craniospinal irradiation (CSI; p = 0.025) were found to positively affect PFS. The 5-year PFS for patients who had CSI vs. whole brain and tumor/tumor bed RT were 44.2% and 15.3%. For the 19 patients who relapsed, 9 (47%) had a recurrence in the RT field, 6 (32%) had a recurrence outside the RT field, and 4 (21%) had a recurrence inside and outside the irradiated field.


CONCLUSIONS
Patients with CPC who received CSI had better PFS compared with those receiving less than CSI. This study supports the use of CSI in the multimodality management of patients with CPC.
Mazloom
Ali
A
Department of Radiation Oncology, The Methodist Hospital, and The Methodist Hospital Research Institute, Houston, TX 77030, USA.
Wolff
Johannes E
JE
Paulino
Arnold C
AC
D000293:Adolescent; D000328:Adult; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016545:Choroid Plexus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016371:Cranial Irradiation / Q000379:methods; D018572:Disease-Free Survival; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D055815:Young Adult