Purpose: We characterized the association between photon radiation dose (< 59.4 versus ≥ 59.4 Gy) and outcomes in intracranial ependymoma. We also examined factors associated with survival after relapse.
Methods: This multi-institutional retrospective study included patients age ≤ 21 years who received postoperative definitive-intent photon radiotherapy for posterior fossa ependymoma between 1997 and 2021. Clinical characteristics were obtained from medical records. Five-year overall (OS) and progression-free (PFS) survival were estimated using the Kaplan-Meier method. Factors associated with progression after radiotherapy, including dose < 59.4 versus ≥ 59.4 Gy, were analyzed using Fine and Gray's proportional subhazards model. Factors associated with post-relapse survival were explored using the Cox proportional-hazards model.
Results: We identified 45 patients meeting inclusion criteria; 48.9% received ≥ 59.4 Gy. There was no difference in 5-year OS or PFS between those who received < 59.4 Gy versus ≥ 59.4 (OS 49.0% vs. 82.9%, p = 0.11; PFS 36.4% vs. 63.9%, p = 0.08); however, there was a trend towards worse 5-year OS and PFS among patients with grade 2 ependymoma who received < 59.4 Gy (OS 48.8% vs. 88.9%, p = 0.06, PFS 40.0% vs. 83.1%, p = 0.08). Only age > 4 years at diagnosis (subdistribution hazard ratio [SHR]: 0.40, p = 0.03) was associated lower risk of progression. Following radiotherapy, 24 patients relapsed. Receipt of salvage systemic therapy was associated with worse post-relapse OS on multivariable analysis (HR = 2.84, p = 0.04).
Conclusion: Underlying biological factors such as age and molecular subtype may hold greater prognostic significance than radiation dose in pediatric ependymoma. Regardless, recurrences are common and outcomes remain poor. Further research into optimal management of relapsed disease is critical.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11060-025-04975-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Tricuspid Annuloplasty Using a Handmade Gore-Tex Band: A Retrospective Study, Case Series, and Literature Review.
Cureus
March 2025
Division of Cardiac Surgery, University Hospital Center "Mother Teresa", Tirana, ALB.
Background Tricuspid valve regurgitation is frequently overlooked by cardiologists and cardiac surgeons alike; consequently, the tricuspid valve is often referred to as "the forgotten" valve. It is the most common complication of left heart valve disease. Ring annuloplasty and suture (De Vega) annuloplasty represent two common surgical treatment techniques.
View Article and Find Full Text PDFHealthcare workers' knowledge, attitudes, and practices on catheter-associated UTI prevention: influencing factors in an OB/GYN hospital.
Front Public Health
March 2025
Department of Hospital Infection Management, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Background: Catheter-associated urinary tract infection (CAUTI) is a leading cause of hospital-acquired infections globally, with a high prevalence in China, especially in high-risk settings like intensive care and post-operative environments. These infections are influenced by factors such as patient volume, healthcare worker training, and adherence to infection control protocols. Shanghai, as a major healthcare hub, faces unique challenges in CAUTI prevention.
View Article and Find Full Text PDFPostoperative Analgesia and Length of Hospital Stay After Surgery for Malignant Pleural Mesothelioma: A Retrospective Observational Study.
Anesth Pain Med
December 2024
Department of Anesthesiology, Hyogo Medical University Faculty of Medicine, Nishinomiya, Hyogo, Japan.
Background: Pleurectomy/decortication (P/D), a surgical procedure for malignant pleural mesothelioma (MPM), is a highly invasive surgery requiring prolonged hospitalization. Previous studies have reported that postoperative analgesia using regional anesthesia contributes to shorter hospital stays after surgery under general anesthesia by reducing acute postoperative pain. However, the association between postoperative analgesia and the length of hospital stay (LOHS) following P/D has not been evaluated.
View Article and Find Full Text PDFSerotonin Syndrome Associated With High-dose Diphenhydramine Use Complicating Abdominoplasty and Mastopexy.
Plast Reconstr Surg Glob Open
March 2025
Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Chappaqua, NY.
Serotonin syndrome is a condition associated with increased serotonergic transmission in the central nervous system. Although shortfalls with diagnostic criteria have led to misleading associations with multiple medications, a possible precipitant is diphenhydramine. Documentation of such an association would prove important for physician practice, as diphenhydramine remains one of the most popular antihistamines available.
View Article and Find Full Text PDFLateral Retrocanthal Orbital Decompression for Children With Thyroid Eye Disease: A Canthus-sparing Approach.
Plast Reconstr Surg Glob Open
March 2025
From the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Thyroid eye disease (TED) is one of the most common causes of proptosis in children. The traditional surgical approach to manage disfiguring proptosis associated with TED is orbital decompression surgery, which is often accomplished via lateral wall decompression through canthotomy and cantholysis. However, this technique can result in lateral canthus scarring and migration.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!