Long-term outcomes of patients with spinal cord gliomas treated by modern conformal radiation techniques.
OBJECTIVE
This study retrospectively examines the long-term therapeutic outcomes of 32 patients with primary spinal cord gliomas at Massachusetts General Hospital between 1991 and 2005 treated by either photon intensity-modulated radiotherapy or conformal proton radiotherapy.


METHODS
Individual patient tumor types included 14 ependymomas, 17 astrocytomas, and one oligodendroglioma. Twenty-two patients were treated with photon beam radiation therapy, and 10 patients were treated with proton beam therapy. The overall survival and time to progression were analyzed. Average radiation dose for patients was 51 Gy in 1.8 median daily fractions over 29 treatments.


RESULTS
For all 32 patients, the overall 5-year survival was 65% and the progression-free survival was 61%, respectively. Overall survival was significantly worse for patients more than 55 years of age (p=0.02). Ependymoma patients had significantly longer survival times than astrocytoma patients (p=0.05). Patients who had undergone a biopsy developed worse outcomes then those with a resection (p=0.05). With the caveat of a limited number of patients, the multivariate model seems to suggest improved overall survival for younger patients (<54 years of age), ependymoma histology, and photon vs. proton treatment.


CONCLUSIONS
For patients with spinal cord gliomas, significant factors associated with patient outcome include tumor pathology, age, extent of surgery, and treatment.
Department of Radiation Oncology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Jenna
J
Kahn
Jay Steven
JS
Loeffler
Andrzej
A
Niemierko
E Antonio
EA
Chiocca
Tracy
T
Batchelor
Arnab
A
Chakravarti
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004806:Ependymoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009837:Oligodendroglioma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017785:Photons / Q000627:therapeutic use; D061766:Proton Therapy; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult; D011522:Protons
D011522:Protons