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Peters S, Merta J, Schmidt L, Jazmati D, Kramer PH, Blase C, Tippelt S, Fleischhack G, Stock A, Bison B, Rutkowski S, Pietsch T, Kortmann RD, Timmermann B. Evaluation of dose, volume and outcome in children with localized, intracranial ependymoma treated with proton therapy within the prospective KiProReg Study. Neuro Oncol 2021; 24:1193-1202. [PMID: 34964901 PMCID: PMC9248402 DOI: 10.1093/neuonc/noab301] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Radiotherapy (RT) of ependymoma in children is an important part of the
interdisciplinary treatment concept. However, feasibility and dose concepts are still
under investigation, particularly in very young children. The aim of this study was to
evaluate the standard dose and volume of proton therapy (PT) in children with
ependymoma. Methods In this analysis, 105 patients with localized, intracranial ependymoma under the age of
18 years treated with PT between 2013 and 2018 were included. Patient characteristics,
treatment, outcome, and follow-up data were analyzed using descriptive statistics,
Kaplan-Meier, and Cox regression analysis. Results The median age of patients at PT was 2.8 years (0.9-17.0 years). The molecular subgroup
analysis was performed in a subset of 50 patients (37 EP-PFA, 2 EP-PFB, 7 EP-RELA, 2
EP-YAP, 2 NEC [not elsewhere classified]). The median total dose was 59.4 Gy (54.0-62.0
Gy). The median follow-up time was 1.9 years. The estimated 3-year overall survival
(OS), local control (LC), and progression-free survival (PFS) rates were 93.7%, 74.1%,
and 55.6%, respectively. Within univariable analysis, female gender and lower dose had a
positive impact on OS, whereas age ≥4 years had a negative impact on OS and PT given
after progression had a negative impact on PFS. In the multivariable analysis, multiple
tumor surgeries were associated with lower PFS. New ≥3° late toxicities occurred in 11
patients. Conclusion For children with localized ependymoma, PT was effective and well tolerable. Multiple
surgeries showed a negative impact on PFS.
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Affiliation(s)
- S Peters
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, Essen, Germany.,Clinic for Particle Therapy, University Hospital Essen, Essen, Germany
| | - J Merta
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, Essen, Germany
| | - L Schmidt
- Clinic for Particle Therapy, University Hospital Essen, Essen, Germany
| | - D Jazmati
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, Essen, Germany.,Clinic for Particle Therapy, University Hospital Essen, Essen, Germany
| | - P H Kramer
- Clinic for Particle Therapy, University Hospital Essen, Essen, Germany
| | - C Blase
- AnästhesieNetz Rhein-Ruhr, Westenfelder, Bochum, Germany
| | - S Tippelt
- Pediatrics III, University Hospital Essen, Essen, Germany
| | - G Fleischhack
- Pediatrics III, University Hospital Essen, Essen, Germany
| | - A Stock
- Department of Neuroradiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - B Bison
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - S Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Pietsch
- Institute of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn Medical Center, Bonn, Germany
| | - R D Kortmann
- Department of Radiotherapy and Radio-oncology, University Hospital Leipzig, Leipzig, Germany
| | - B Timmermann
- West German Proton Therapy Center Essen (WPE), University Hospital Essen, Essen, Germany.,Clinic for Particle Therapy, University Hospital Essen, Essen, Germany.,West German Cancer Center (WTZ). University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK), Germany
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Peters S, Frisch S, Stickan-Verfuerth M, Plaude S, Blase C, Tippelt S, Timmermann B. Proton Beam Therapy for Ependymomas of Childhood; Early Data From the Prospective KiProReg Registry. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.01.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vogt S, Karatolios K, Wittek A, Fritzen C, Blase C, Moosdorf R. Cyclic Longitudinal and Circumferential Deformation of the Ascending and Abdominal Aorta Measured by 3D Ultrasound Combined with Speckle Tracking. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wittek A, Bihari P, Shelke A, Nwe T, Nelson K, Karatolios K, Vogt S, Moosdorf R, Schmitz-Rixen T, Blase C. IN VIVO DETERMINATION OF ELASTIC PROPERTIES OF THE HUMAN AORTA BASED ON 4D ULTRASOUND DATA. J Biomech 2012. [DOI: 10.1016/s0021-9290(12)70020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vogt S, Karatolios K, Wittek A, Nwe T, Gorissen W, Zahn M, Silber G, Blase C, Maisch B, Moosdorf R. In vivo vascular modelling of abdominal aorta based on 3D speckle tracking analysis*. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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