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Maximally safe resection followed by hypofractionated re‐irradiation for locally recurrent ependymoma in children
Author(s) -
Liu Arthur K.,
Foreman Nicholas K.,
Gaspar Laurie E.,
Trinidad Elizabeth,
Handler Michael H.
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21982
Subject(s) - medicine , ependymoma , radiation therapy , regimen , surgery , population , environmental health
Background Treatment failure in children with ependymoma is relatively common, with the majority of events consisting of local failure. Salvage therapy for these children historically had poor results, with repeated local recurrences. To improve these outcomes, we began to offer hypofractionated re‐irradiation after resection at first local recurrence. To minimize the duration of therapy, we chose a hypofractionated regimen that has been shown to be well tolerated in adult patients. Procedure We performed a review of the experience at the Children's Hospital in Denver and at the Department of Radiation Oncology at the University of Colorado Denver from 1995 to 2008 with hypofractionated re‐irradiation after maximally safe resection in children with locally recurrent ependymoma. Results Six children with locally recurrent ependymoma were seen in that time period. After maximally safe resection, all six received hypofractionated radiation therapy of 24–30 Gy delivered in three fractions. With a median follow‐up of 28 months from the time of re‐irradiation, all six children are alive with no evidence of disease. Three children had evidence of radiation necrosis, either clinically or based on imaging, but none required significant intervention. Conclusions Hypofractionated re‐irradiation after resection for locally recurrent ependymoma is well tolerated. This approach also appears to provide good local control. Additional follow‐up is required to determine the efficacy and potential late effects of hypofractionated re‐irradiation in this patient population. Pediatr Blood Cancer 2009;52:804–807. © 2009 Wiley‐Liss, Inc.