Survival outcomes for radiotherapy treatment of epidermoid tumors with malignant transformation.
Epidermoid tumors are intracranial lesions that may occasionally undergo malignant transformation. Although surgical resection is the first-line treatment for malignant epidermoids, postoperative radiotherapy has been intermittently reported with favorable findings. Our analysis identified all previously reported patients with malignant epidermoids treated with surgical resection alone or surgery plus radiotherapy to examine the potential role for this adjuvant therapy. Whereas patients treated with surgery only had an overall survival of 6.6 months, those treated with postoperative radiotherapy demonstrated a statistically significant increase in survival to 12.7 months (log-rank test, p<0.003). Furthermore, the mean dosage of radiation given to this patient population was 52.2 Gy, with no appreciable survival benefit for the utilization of levels of radiation greater than 50 Gy. When determining the management for malignant transformation of epidermoid tumors, the combination of surgical resection and radiotherapy may be associated with improved short-term survival.
Department of Neurological Surgery, University of California Los Angeles, 695 Charles E. Young Drive South, Gonda 3357, Los Angeles, CA 90095-1761, USA.
Daniel
D
Nagasawa
Andrew
A
Yew
Marko
M
Spasic
Winward
W
Choy
Quinton
Q
Gopen
Isaac
I
Yang
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000473:pathology*; D003131:Combined Modality Therapy / Q000379:methods; D004814:Epidermal Cyst / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D055756:Meningeal Carcinomatosis / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D019635:Neurosurgical Procedures / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D015996:Survival Rate / Q000639:trends; D055815:Young Adult