Grabenbauer G G, Barta B, Erhardt J, Buchfelder M, Thierauf P, Beck J D, Sauer R
Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.
Strahlenther Onkol. 1992 Dec;168(12):679-85.
Between 1978 and 1991, 31 patients with primary (n = 28) and recurrent (n = 3) ependymoma received external radiation after initial surgery. There were 26 cases of intracranial and five cases of spinal ependymoma. Histological grading revealed low-grade in 23 and high-grade tumors in eight patients. Craniospinal irradiation was given to 13 of 28 patients, whole cranial radiation with boost to posterior fossa in three and local treatment to twelve patients. Six of 28 patients received chemotherapy. Dose to the primary, tumor localisation, grading and extend of surgery did not significantly impact on survival and relapse-free survival. Age was a marginally significant prognostic factor for survival. In patients with intracranial ependymoma (n = 24) survival and relapse-free survival at five years were 54% and 42%, respectively. Patterns of recurrence showed a local recurrence alone in eight, a CNS-relapse with local recurrence in four and local recurrence with distant metastases in one case. Spinal seeding occurred in two of 13 after craniospinal irradiation and two of twelve patients after local treatment. The main problem in the treatment of ependymoma remains local control, the use of spinal irradiation does not seem to improve treatment results.
1978年至1991年间，31例原发性（n = 28）和复发性（n = 3）室管膜瘤患者在初次手术后接受了外照射。其中颅内室管膜瘤26例，脊髓室管膜瘤5例。组织学分级显示，23例为低级别肿瘤，8例为高级别肿瘤。28例患者中，13例接受了全脑脊髓照射，3例接受了全脑照射并加量照射后颅窝，12例接受了局部治疗。28例患者中有6例接受了化疗。原发灶剂量、肿瘤定位、分级及手术范围对生存率和无复发生存率无显著影响。年龄是影响生存的一个边缘性显著预后因素。颅内室管膜瘤患者（n = 24）的5年生存率和无复发生存率分别为54%和42%。复发模式显示，仅局部复发8例，中枢神经系统复发伴局部复发4例，局部复发伴远处转移1例。13例接受全脑脊髓照射的患者中有2例发生脊髓播散，12例接受局部治疗的患者中有2例发生脊髓播散。室管膜瘤治疗的主要问题仍然是局部控制，使用脊髓照射似乎并不能改善治疗效果。
