دورية أكاديمية
Effect of Postoperative Radiation Therapy Timing on Survival in Pediatric and Young Adult Ependymoma
| العنوان: | Effect of Postoperative Radiation Therapy Timing on Survival in Pediatric and Young Adult Ependymoma |
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| المؤلفون: | Sunny Shah, MS, Kevin Gates, MS, Chase Mallory, BHS, Muni Rubens, PhD, MPH, Ossama M. Maher, MD, Toba N. Niazi, MD, Ziad Khatib, MD, Rupesh Kotecha, MD, Minesh P. Mehta, MD, Matthew D. Hall, MD, MBA |
| المصدر: | Advances in Radiation Oncology, Vol 6, Iss 4, Pp 100691- (2021) |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Purpose: Postoperative radiation therapy (RT) is commonly used for World Health Organization grade II-III intracranial ependymoma. Clinicians generally aim to begin RT ≤5 weeks after surgery, but postoperative recovery and need for second look surgery can delay the initiation of adjuvant therapy. On ACNS 0831, patients were required to enroll ≤8 weeks after initial surgery and begin adjuvant therapy within 3 weeks after enrollment. The purpose of this study was to determine the optimal timing of RT after surgery. Methods and Materials: The National Cancer Database was queried for patients (aged 1-39 years) with localized World Health Organization grade II-III intracranial ependymoma treated with surgery and postoperative RT. Overall survival (OS) curves were plotted based on RT timing (≤5 weeks, 5-8 weeks, and >8 weeks after surgery) and were compared by log-rank test. Factors associated with OS were identified by multivariate analysis. After 2009, complete data were available on whether patients underwent gross total resection or subtotal resection. Planned subset analysis was performed to examine the effect of RT timing on OS in patients with known extent of resection. Results: In the final analytical data set of 1043 patients, no difference in 3-year OS was observed in patients who initiated RT ≤5 weeks, 5 to 8 weeks, and >8 weeks after surgery (89.8% vs 89.1% vs 88.4%; P = .796). On multivariate analysis, grade III tumors (hazard ratio, 2.752; 95% confidence interval, 1.969-3.846, P < .001) and subtotal resection (hazard ratio, 2.253; 95% confidence interval, 1.405-3.611, P < .001) were significantly associated with reduced OS. Timing of RT, total RT dose, age, and other factors were not significant. These findings were affirmed in the subset of patients treated between 2010 and 2016, when extent of resection was routinely recorded. Conclusions: Delayed postoperative RT was not associated with inferior survival in patients with intracranial ependymoma. Delayed RT initiation may be acceptable in patients who require longer postoperative recovery or referral to an appropriate RT center, but should be minimized whenever practical. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2452-1094 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S245210942100049X; https://doaj.org/toc/2452-1094 |
| DOI: | 10.1016/j.adro.2021.100691 |
| URL الوصول: | https://doaj.org/article/8e26e6b80dc74ca8bbed156cdcfba42f |
| رقم الأكسشن: | edsdoj.8e26e6b80dc74ca8bbed156cdcfba42f |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 24521094 |
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| DOI: | 10.1016/j.adro.2021.100691 |