Fractionated stereotactic radiosurgery for recurrent ependymoma  in children.
Outcomes for children with relapsed ependymoma are poor. Re-irradiation is a potentially viable salvage option in these patients. Data were reviewed for 12 patients (median age 5.6 years) with relapsed ependymoma who received fractionated stereotactic radiosurgery (fSRS) following maximal surgical resection from 1995 to 2012. Four patients experienced a second recurrence, including 2 in-field and 2 distant failures. Median time to second recurrence (32 months) was significantly longer than time to first recurrence (24 months) (p = 0.008). Three-year local control was 89 %, and median event free survival from fSRS was 3.4 years. Radiation necrosis was observed in 6 patients, 3 who were symptomatic. In conclusion, fSRS offers durable response with a tolerable toxicity profile in children with recurrent EPN.
Lindsey M
LM
Hoffman
S Reed
SR
Plimpton
Nicholas K
NK
Foreman
Nicholas V
NV
Stence
Todd C
TC
Hankinson
Michael H
MH
Handler
Molly S
MS
Hemenway
Rajeev
R
Vibhakar
Arthur K
AK
Liu
D000293:Adolescent; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000601:surgery*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome