Behandlungsergebnisse der Strahlentherapie beim primären Rückenmarksgliom

Translated title of the contribution: Treatment outcomes of radiotherapy for primary spinal cord glioma

Seo Hee Choi, Hong In Yoon, Seong Yi, Jong Won Park, Jaeho Cho, DongAh Shin, Yoon Ha, Dong Seok Kim, SeHoon Kim, Seung Koo Lee, Jong Hee Chang, Chang-Ok Suh

Research output: Contribution to journalArticle

Abstract

Purpose: Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen. Methods: We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82%) received postoperative RT, 6 (13%) underwent definitive RT without surgery, and 2 (5%) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy). Results: In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2‑year overall survival and progression-free survival rates were 74 and 54%, respectively. Overall, 13 (32%) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with diverse prognosis. In grade IV tumors, seeding developed in 45%. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50%, p < 0.001). Conclusion: To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.

Original languageGerman
Pages (from-to)164-174
Number of pages11
JournalStrahlentherapie und Onkologie
Volume195
Issue number2
DOIs
Publication statusPublished - 2019 Feb 6

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Glioma
Spinal Cord
Radiotherapy
Survival
Neoplasms
Craniospinal Irradiation
Disease-Free Survival
Survival Rate
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

Choi, Seo Hee ; Yoon, Hong In ; Yi, Seong ; Park, Jong Won ; Cho, Jaeho ; Shin, DongAh ; Ha, Yoon ; Kim, Dong Seok ; Kim, SeHoon ; Lee, Seung Koo ; Chang, Jong Hee ; Suh, Chang-Ok. / Behandlungsergebnisse der Strahlentherapie beim primären Rückenmarksgliom. In: Strahlentherapie und Onkologie. 2019 ; Vol. 195, No. 2. pp. 164-174.
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abstract = "Purpose: Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen. Methods: We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82{\%}) received postoperative RT, 6 (13{\%}) underwent definitive RT without surgery, and 2 (5{\%}) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy). Results: In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2‑year overall survival and progression-free survival rates were 74 and 54{\%}, respectively. Overall, 13 (32{\%}) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23{\%}, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45{\%} with diverse prognosis. In grade IV tumors, seeding developed in 45{\%}. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50{\%}, p < 0.001). Conclusion: To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.",
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Behandlungsergebnisse der Strahlentherapie beim primären Rückenmarksgliom. / Choi, Seo Hee; Yoon, Hong In; Yi, Seong; Park, Jong Won; Cho, Jaeho; Shin, DongAh; Ha, Yoon; Kim, Dong Seok; Kim, SeHoon; Lee, Seung Koo; Chang, Jong Hee; Suh, Chang-Ok.

In: Strahlentherapie und Onkologie, Vol. 195, No. 2, 06.02.2019, p. 164-174.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Behandlungsergebnisse der Strahlentherapie beim primären Rückenmarksgliom

AU - Choi, Seo Hee

AU - Yoon, Hong In

AU - Yi, Seong

AU - Park, Jong Won

AU - Cho, Jaeho

AU - Shin, DongAh

AU - Ha, Yoon

AU - Kim, Dong Seok

AU - Kim, SeHoon

AU - Lee, Seung Koo

AU - Chang, Jong Hee

AU - Suh, Chang-Ok

PY - 2019/2/6

Y1 - 2019/2/6

N2 - Purpose: Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen. Methods: We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82%) received postoperative RT, 6 (13%) underwent definitive RT without surgery, and 2 (5%) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy). Results: In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2‑year overall survival and progression-free survival rates were 74 and 54%, respectively. Overall, 13 (32%) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with diverse prognosis. In grade IV tumors, seeding developed in 45%. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50%, p < 0.001). Conclusion: To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.

AB - Purpose: Spinal cord gliomas are rare, and there is no consensus on the optimal radiotherapy (RT) regimen. Herein, we investigated therapeutic outcomes in spinal cord gliomas to obtain clues for the optimal RT regimen. Methods: We assessed 45 patients who received RT for primary spinal cord non-ependymoma gliomas between 2005 and 2017: 37 (82%) received postoperative RT, 6 (13%) underwent definitive RT without surgery, and 2 (5%) received salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40 Gy) was administered in 4 patients with seeding at diagnosis; all other patients received local RT only (median, 50.4 Gy). Results: In all 23 failures occurred (20 in patients without initial seeding +3 in patients with initial seeding and CSI; median follow-up, 33 months). The 2‑year overall survival and progression-free survival rates were 74 and 54%, respectively. Overall, 13 (32%) new seeding events outside the local RT field developed either first or subsequently. Tumor grade was significantly associated with survival endpoints (p = 0.009, 0.028) and overall seeding rates (p = 0.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with diverse prognosis. In grade IV tumors, seeding developed in 45%. The survival of patients with newly developed seeding was significantly worse than the others (2-year 50%, p < 0.001). Conclusion: To encompass a considerable rate of progressive disease seeding, aggressive treatment such as pre-emptive application of CSI needs to be considered for high-grade spinal cord gliomas with adverse features. Prophylactic CSI could be an option for survival prolongation and requires prospective validation.

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