Prognostic Factors and Survival Outcomes of Intracranial Ependymoma Treated with Multimodality Approach.
Indian J Med Paediatr Oncol
; 38(4): 420-426, 2017.
Article
in En
| MEDLINE
| ID: mdl-29333005
ABSTRACT
OBJECTIVES:
We aimed to analyze treatment outcomes of intracranial ependymoma (ICE) treated at our institute with multimodality approach. MATERIALS ANDMETHODS:
Demography, treatment details, and survival data of 40 patients (2005-2012) were collected in a predesigned pro forma. Kaplan Meier method was used to analyze disease-free survival (DFS) and the impact of prognostic factors was determined using univariate analysis (log-rank test). Multivariate analysis was performed using Cox-proportional hazard model. SPSS version 21.0 was used for all statistical analysis.RESULTS:
Malefemale ratio was 2911. Gross total resection subtotal resection or less was 42.5% 57.5%. A total of 16 patients (40%) had anaplastic histology. All except two patients received adjuvant radiotherapy. Four patients received concurrent chemotherapy (temozolomide [TMZ]) and 10 patients received adjuvant chemotherapy (6 carboplatin plus etoposide; 4 TMZ). Median follows up was 18 months (2-60 months). Median DFS for the entire cohort was 22.42 months. The estimated 1, 2, and 3 years DFS was found to be 58.5%, 41%, and 30.7%, respectively. On univariate analysis, patients receiving higher radiation dose (56 Gray vs. 60 Gray; hazard ratio [HR] 0.366; 95% confidence interval [CI] 0.142-0.9553; P = 0.02) and lower MIB labeling index (<20 vs. ≥20; HR 0.238; 95% CI 0.092-0.617; P = 0.001) had a better DFS. Higher radiation dose continued to be an independent prognostic factor on multivariate analysis (HR 0.212; 95% CI 0.064-0.856; P = 0.03).CONCLUSION:
ICE has guarded prognosis. Adjuvant radiotherapy to a higher radiation dose improves survival. Higher MIB labeling index connotes a dismal survival despite the use of radiotherapy and chemotherapy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Prognostic_studies
Language:
En
Journal:
Indian J Med Paediatr Oncol
Year:
2017
Document type:
Article
Affiliation country:
India