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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

Chemotherapy for intracranial ependymoma in adults

Authors: Dorothee Gramatzki, Patrick Roth, Jörg Felsberg, Silvia Hofer, Elisabeth J. Rushing, Bettina Hentschel, Manfred Westphal, Dietmar Krex, Matthias Simon, Oliver Schnell, Wolfgang Wick, Guido Reifenberger, Michael Weller

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

Ependymal tumors in adults are rare, accounting for less than 4 % of primary tumors of the central nervous system in this age group. The low prevalence of intracranial ependymoma in adults limits the ability to perform clinical trials. Therefore, treatment decisions are based on small, mostly retrospective studies and the role of chemotherapy has remained unclear.

Methods

We performed a retrospective study on 17 adult patients diagnosed with intracranial World Health Organisation grade II or III ependymoma, who were treated with chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by applying Macdonald criteria. Progression-free (PFS) and overall survival (OS) were calculated from start of chemotherapy, using the Kaplan-Meier method.

Results

Eleven patients had supratentorial and 6 infratentorial tumors. Ten patients were treated with temozolomide (TMZ), 3 with procarbazine/lomustine/vincristine (PCV), 3 with platinum-based chemotherapy and 1 patient received epirubicin/ifosfamide. Response rates were as follows: TMZ 8/10 stable disease; PCV 3/3 stable disease; platinum-based chemotherapy 1/3 partial response; epirubicin/ifosfamide 1/1 complete response. PFS rates at 6, 12 and 24 months were 52.9, 35.3 and 23.5 %. OS rates at 6, 12 and 24 months were 82.4, 82.4 and 70.1 %. There was no indication for a favourable prognostic role of O 6 -methylguanyl-DNA-methyltransferase (MGMT) promoter methylation which was detected in 3/12 investigated tumors.

Conclusions

Survival outcomes in response to chemotherapy in adult intracranial ependymoma patients vary substantially, but individual patients may respond to any kind of chemotherapy. There were too few patients to compare survival data between chemotherapeutic subgroups.
Appendix
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Metadata
Title
Chemotherapy for intracranial ependymoma in adults
Authors
Dorothee Gramatzki
Patrick Roth
Jörg Felsberg
Silvia Hofer
Elisabeth J. Rushing
Bettina Hentschel
Manfred Westphal
Dietmar Krex
Matthias Simon
Oliver Schnell
Wolfgang Wick
Guido Reifenberger
Michael Weller
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2323-0

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