1Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
2Department of Pathology, Severance Hospital, Yonsei University Health System, Seoul, Korea
3Department of Neurosurgery, Severance Hospital, Yonsei University Health System, Seoul, Korea
4Department of Pediatrics, Severance Hospital, Yonsei University Health System, Seoul, Korea
Copyright © 2015 by the Korean Cancer Association
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Characteristic | No. (%) |
---|---|
Age at diagnosis (yr) | |
≤ 3 | 12 (11.3) |
> 3 and ≤ 10 | 55 (51.9) |
> 10 and ≤ 30 | 32 (30.2) |
> 30 | 7 (6.6) |
Gender | |
Male | 67 (63.2) |
Female | 39 (36.8) |
Initial imaging modality | |
Brain MRI/CT | 4 (3.8) |
Brain MRI/CT+spinal MRI | 102 (96.2) |
CSF study | |
Negative | 76 (71.7) |
Positive | 21 (19.8) |
Not performed | 9 (8.5) |
M staging | |
0 | 64 (60.4) |
1 | 9 (8.5) |
2 | 5 (4.7) |
3 | 24 (22.6) |
Unknown | 4 (3.8) |
Extent of surgery | |
GTR/NTR | 56 (52.8) |
STR | 50 (47.2) |
Treatment year | |
1992-1999 | 52 (49.1) |
2000-2009 | 54 (50.9) |
Histological subtype | |
Classic | 57 (53.8) |
Desmoplastic/extensive nodular | 26 (24.5) |
Anaplastic/large cell | 2 (1.9) |
Unknown | 21 (19.8) |
Use of combined chemotherapy | |
Yes | 88 (83.0) |
No | 18 (17.0) |
CSI dose (Gy) | |
No CSI | 4 (3.8) |
≤ 30 | 14 (13.2) |
> 30 and ≤ 36 | 70 (66.0) |
> 36 | 18 (17.0) |
Tumor bed total dose (Gy) | |
No RT | 1 (0.9) |
< 50 | 4 (3.8) |
≥ 50 and < 54 | 2 (1.9) |
≥ 54 | 99 (93.4) |
Surgery-RT interval (mo) | |
≤ 1 | 57 (53.8) |
>1 and ≤ 2 | 30 (28.3) |
> 2 and ≤ 3 | 7 (6.6) |
> 3 | 12 (11.3) |
Factor | No | Event-free survival (%) |
Overall survival (%) |
|||||
---|---|---|---|---|---|---|---|---|
5-Year | 10-Year | p-value | 5-Year | 10-Year | p-value | |||
Gender | Male | 67 | 63.3 | 59.5 | 0.189 | 71.3 | 60.2 | 0.280 |
Female | 39 | 53.0 | 49.4 | 61.2 | 53.7 | |||
Age (yr) | ≤ 3 | 12 | 50.0 | 50.0 | 0.603 | 50.0 | 50.0 | 0.701 |
> 3 and ≤ 10 | 55 | 65.1 | 60.5 | 68.7 | 59.6 | |||
> 10 and ≤ 30 | 32 | 56.8 | 53.1 | 71.1 | 59.8 | |||
>30 | 7 | 42.9 | 42.9 | 71.4 | 47.6 | |||
Age and risk factor | ≤ 3yr | 12 | 50.0 | 50.0 | 0.562 | 50.0 | 50.0 | 0.395 |
> 3 yr and (≥ M2 and/or STR) | 59 | 56.8 | 54.9 | 67.6 | 56.8 | |||
> 3 yr and (MO-1 and GTR/NTR) | 35 | 67.4 | 57.2 | 73.3 | 61.1 | |||
M staging | 0-1 | 73 | 64.9 | 59.4 | 0.091 | 73.5 | 60.5 | 0.185 |
2-3 | 29 | 50.5 | 50.5 | 58.6 | 55.0 | |||
Histology | Classic | 57 | 67.8 | 65.4 | 0.444 | 71.5 | 66.3 | 0.439 |
Desmoplastic/EN | 26 | 52.9 | 44.8 | 65.2 | 47.6 | |||
Anaplastic/large cell | 2 | 50.0 | NA | 50.0 | NA | |||
Surgery extent | GTR/NTR | 56 | 63.8 | 58.2 | 0.699 | 67.3 | 60.9 | 0.843 |
STR | 50 | 55.0 | 52.7 | 67.8 | 55.0 | |||
Treatment year | 1992-1999 | 52 | 51.2 | 51.2 | 0.247 | 61.5 | 53.8 | 0.363 |
2000-2009 | 54 | 67.8 | 58.5 | 73.6 | 60.3 | |||
Combined chemotherapy | No | 18 | 43.2 | 43.2 | 0.102 | 61.1 | 54.3 | 0.340 |
Yes | 88 | 62.9 | 58.5 | 68.9 | 58.9 | |||
CSI dose (Gy) | < 30 | 14 | 57.1 | NA | 0.653 | 62.5 | NA | 0.454 |
≥ 30 | 92 | 60.2 | 56.2 | 68.3 | 59.2 | |||
Tumor bed dose (Gy) | < 50 | 5 | 20.0 | NA | 0.002 | 20.0 | NA | < 0.001 |
≥ 50 | 101 | 61.6 | 57.8 | 70.0 | 60.0 | |||
Surgery-RT interval (mo) | < 3 | 94 | 62.0 | 57.9 | 0.179 | 71.0 | 60.4 | 0.059 |
≥ 3 | 12 | 50.0 | 50.0 | 50.0 | 50.0 |
Site | No. (%) |
---|---|
Posterior fossa+intracranial (n=22) | |
Tumor bed | 5 (17.2) |
Posterior fossa other than tumor bed | 5 (17.2) |
Supratentorium | 9(31.0) |
Tumor bed+supratentorium | 1 (3.4) |
Posterior fossa+supratentorium | 2 (6.9) |
Combined spinal (n=7) | |
Spine alone | 6 (20.7) |
Posterior fossa+spine | 1 (3.4) |
No. | Recurrent sites | Age (yr)/Gender | Initial M | CSI dose (Gy) | Tumor bed dose (Gy) | RFI (mo) | Salvage treatment | Re-RT dose (total/fractional, Gy) | Postrecur survival (mo)/last status |
---|---|---|---|---|---|---|---|---|---|
1 | Spine | 6/F | MO | 36 | 54 | 13.9 | Chemo/RT | 30.6/1.8 | 4/DWD |
2 | Supratentorium (3rd ventricle) | 10/F | MO | 36 | 54 | 11.5 | Chemo/GK-RS | 20/20 | 5/DWD |
3 | Supratentorium (frontal+periventricle) | 12/M | MO | 36 | 54 | 27.3 | Chemo/RT | 31.2/1.2 | 10/DWD |
4 | Spine | 36/M | MO | 0 | 54 | 28.7 | RT | Spine: 45/1.5, WB: 30.9/1.5 | 70/DWD |
5 | Supratentorium (parietal lobe) | 19/M | M3 | 36 | 54 | 14.5 | Chemo/RT | 41.4/1.8 | 143/NED |
6 | Posterior fossa +supratentorium (basal ganglia) | 24/M | MO | 36 | 59.4 | 54.7 | Chemo/RT | CSI: 19.5/1.5, local boost: 20/2 | 8/DWD |
7 | Spine | 6/M | M3 | 36 | 55.8 | 16.5 | Chemo/RT | 19.8/1.8 | 48/DWD |
8 | Supratentorium (subfrontal) | 7/M | MO | 36 | 55.8 | 18.2 | Surgery/chemo/RT | 36/1.8 | 16/DWD |
9 | Spine | 10/F | M3 | 39 | 55.2 | 18.8 | RT | 19.5/1.5 | 8/DWD |
10 | Supratentorium (subfrontal) | 5/F | M3 | 42 | 54.6 | 17.1 | RT | 6/2 (interrupted due to death) | 1/DWD |
11 | Supratentorium (subfrontal) | 6/M | M3 | 30.6 | 54 | 5.7 | Chemo/RT | 36/1.8 | 9/DWD |
12 | Spine | 15/F | MO | 36 | 54 | 36.2 | Surgery/chemo/RT | 36/1.8 (spine+sacrum) | 41/NED |
MRI, magnetic resonance imaging; CT, computed tomography; CSF, cerebrospinal fluid; GTR, gross total resection; NTR, near total resection; STR, subtotal resection; CSI, craniospinal irradiation; RT, radiation therapy.
STR, subtotal resection; GTR, gross total resection; NTR, near total resection; EN, extensive nodular; NA, not available; CSI, craniospinal irradiation; RT, radiation therapy.
CSI, craniospinal irradiation; RFI, relapse-free interval; Re-RT, reirradiation; F, female; RT, radiation therapy; DWD, die with disease; GK-RS, gamma-knife radiosurgery; M, male; WB, whole brain; NED, no evidence of disease.