Prognostic factors for 31 cases of intracranial ependymomas after postoperative radiotherapy

Abstract

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs). Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively. Twenty-two males and 9 females had an average age of 18 years (range 3-60 years). Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR). Median total radiation dose was 53.9 Gy(48.6-60 Gy). The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing. Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs. Results The median time of follow-up was 51 months. At the endpoint of the follow-up period, 7 patients experienced tumor recurrence: 5 had a local recurrence (LR) and 2 had both LR and distant recurrence. Six patients died, 4 of which had cases of pediatric infratentorial anaplastic EPs. The three and five-year progress-free survival (PFS) were 80.6% and 75.9%. Overall survival (OS) at three-year and five-year were 83.9% and 76.2%, respectively. Univariate analysis showed a more favorable prognoses in terms of three-year PFS, five-year PFS and OS for GTR compared to STR (χ2=4.685, 6.311, 4.238, P 55 Gy compared to ≤55 Gy (χ2=4.210, P<0.05), and no severe radiotherapy complications occurred. Conclusions Surgery is the major treatment method, while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients. Surgical resection and radiotherapy dose were relevant to prognosis. Key words: Ependymomas; Surgery; Radiotherapy; Prognostic factors