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Anticancer Res. 2013 Jun;33(6):2611-8.

Wide-field pulsed reduced dose rate radiotherapy (PRDR) for recurrent ependymoma in pediatric and young adult patients.

Author information

  • 1Department of Human Oncology, University of Wisconsin Hospital and Clinics, Paul P Carbone Cancer Center, Madison, WI, USA. pmohindra@uwhealth.org

Abstract

AIM:

This retrospective analysis evaluates feasibility of wide-field re-irradiation using pulsed reduced dose rate (PRDR) technique in patients with recurrent ependymoma. PRDR employs a dose rate of 6 cGy/min, as opposed to 400-600 cGy/min for conventional radiation, allowing for enhanced normal tissue repair.

PATIENTS AND METHODS:

Five patients with recurrent ependymoma having eight lesions (two brain, six spinal cord) were treated with PRDR. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan Meier method.

RESULTS:

The median interval between two radiation courses was 58 months (range: 32-212 months). The median PRDR dose was 40 Gy (range: 30.6-54 Gy) with a median cumulative lifetime dose of 105.2 Gy (range: 90-162.4 Gy). At a median post-PRDR follow-up of 64 months, estimated 4-year OS and PFS from PRDR was 60% and 35.7%, respectively. None of the patients developed necrosis on serial magnetic resonance imaging scans, and only one patient had progressive mild radiculopathy.

CONCLUSION:

In patients with large-volume recurrent ependymoma, re-irradiation with wide-field PRDR is a feasible option.

KEYWORDS:

Re-irradiation; ependymoma; pulsed reduced dose-rate radiotherapy

PMID:
23749916
[PubMed - indexed for MEDLINE]
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