Department of Radiation Oncology/Brain Tumor and Neuro-Oncology Center, Cleveland, Ohio 44195, USA.
J Neurosurg Spine. 2011 Jan;14(1):59-64. doi: 10.3171/2010.9.SPINE09920. Epub 2010 Dec 3.
the goal in this study was to determine the role of radiation therapy (RT) in the treatment of spinal myxopapillary ependymomas (MPEs).
thirty-seven patients with histologically verified spinal MPEs were reviewed. Kaplan-Meier analyses and Cox proportional hazard regression were used to determine what patient and treatment factors influenced overall survival (OS) and recurrence.
at the time of initial diagnosis, the median age was 33 years and the Karnofsky Performance Scale score was 80. In 86.5% of cases, the most common presenting symptom was pain. All patients received surgery as their initial treatment. Nine patients also received RT along with surgery, with a median total dose of 50.2 Gy. The mean survival time was 12.2 years; however, only 4 of 37 patients had died at the time of this study. None of the patient or treatment parameters significantly correlated with OS. Sixteen patients (43.2%) were found to have a recurrence, with a median time to recurrence of 7.7 years. None of the patient or treatment parameters correlated with recurrence-free survival for an initial recurrence. The median time to the second recurrence (recurrence following therapy for initial recurrence) was 1.6 years. Use of RT as salvage therapy after initial recurrence significantly correlated with longer times to a second recurrence. The median recurrence-free survival time before the second recurrence was 9.6 years for those who received RT versus 1.1 years for those who did not receive RT (p = 0.0093). None of the other parameters significantly correlated with a second recurrence.
radiation therapy may have a role as salvage therapy in delaying recurrences of spinal MPEs.
本研究旨在确定放射治疗（RT）在脊髓黏液乳头状室管膜瘤（MPE）治疗中的作用。
回顾了 37 例经组织学证实的脊髓 MPE 患者。采用 Kaplan-Meier 分析和 Cox 比例风险回归分析，确定哪些患者和治疗因素影响总生存率（OS）和复发。
在初始诊断时，中位年龄为 33 岁，卡诺夫斯基表现量表评分为 80 分。在 86.5%的病例中，最常见的首发症状是疼痛。所有患者均接受手术作为初始治疗。9 例患者还接受了手术加放疗，总剂量中位数为 50.2Gy。平均生存时间为 12.2 年；然而，在本研究时，仅有 4 例患者死亡。患者和治疗参数均与 OS 无显著相关性。16 例（43.2%）患者发现复发，中位复发时间为 7.7 年。患者和治疗参数与初始复发后的无复发生存率均无相关性。初始复发后接受 RT 治疗的第二次复发的中位时间为 1.6 年。初始复发后使用 RT 作为挽救性治疗与第二次复发的时间延长显著相关。接受 RT 治疗的患者第二次复发前的无复发生存时间中位数为 9.6 年，未接受 RT 治疗的患者为 1.1 年（p = 0.0093）。其他参数与第二次复发均无显著相关性。
RT 可能作为挽救性治疗在延迟脊髓 MPE 复发方面发挥作用。
