Therapy outcomes of radiotherapy for major spinal wire glioma.
Strahlenther Onkol. 2018 Sep 10;:
Authors: Choi SH, Yoon HI, Yi S, Park JW, Cho J, Shin DA, Ha Y, Kim DS, Kim SH, Lee SK, Chang JH, Suh CO
PURPOSE: Spinal wire gliomas are uncommon, and there’s no consensus on the optimum radiotherapy (RT) routine. Herein, we investigated therapeutic outcomes in spinal wire gliomas to acquire clues for the optimum RT routine.
METHODS: We assessed 45 sufferers who acquired RT for major spinal wire non-ependymoma gliomas between 2005 and 2017: 37 (82%) acquired postoperative RT, 6 (13%) underwent definitive RT with out surgical procedure, and a pair of (5%) acquired salvage RT for recurrent tumors. Craniospinal irradiation (CSI; median, 40?Gy) was administered in four sufferers with seeding at analysis; all different sufferers acquired native RT solely (median, 50.four?Gy).
RESULTS: In all 23 failures occurred (20 in sufferers with out preliminary seeding +three in sufferers with preliminary seeding and CSI; median follow-up, 33 months). The two?yr general survival and progression-free survival charges have been 74 and 54%, respectively. General, 13 (32%) new seeding occasions exterior the native RT subject developed both first or subsequently. Tumor grade was considerably related to survival endpoints (p?=?zero.009, zero.028) and general seeding charges (p?=?zero.042). In grade II tumors, seeding developed in 23%, with a dismal prognosis (median, 10 months after RT). In grade III tumors, seeding developed in 45% with various prognosis. In grade IV tumors, seeding developed in 45%. The survival of sufferers with newly developed seeding was considerably worse than the others (2-year 50%, p?<?zero.001).
CONCLUSION: To embody a appreciable fee of progressive illness seeding, aggressive remedy resembling pre-emptive software of CSI must be thought-about for high-grade spinal wire gliomas with adversarial options. Prophylactic CSI may very well be an possibility for survival prolongation and requires potential validation.
PMID: 30203111 [PubMed – as supplied by publisher]