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Aggressive Treatment Effective in Kids' Brain Cancer
Date:1/31/2009

Newer radiotherapy delivery systems cut dose, side effects after rare disease surgery

SATURDAY, Jan. 31 (HealthDay News) -- The best way to treat a rare form of childhood brain cancer called ependymoma is aggressive surgery followed by targeted radiotherapy, U.S. researchers say.

Ependymoma affects the central nervous system. Aggressive surgery has proven effective, but concerns about side effects have limited the use of radiation therapy.

In this study, Dr. Thomas Merchant, of St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues used surgery and computer-guided radiotherapy to treat 153 patients, including some under the age of 3. During a median of 5.3 years of follow-up, tumor progression occurred in 36 patients, and 23 patients died.

The researchers calculated the overall rate of event-free survival after seven years to be 69.1 percent and overall survival to be 81 percent. Patients who had radiotherapy immediately after surgery had higher event-free survival and overall survival rates -- 76.9 percent and 85 percent, respectively.

The estimated overall rate of local tumor control after seven years was 87.3 percent. Treatment was generally well-tolerated by the patients, said the study, which was published online and in the March print issue of The Lancet Oncology.

"This study highlights the long-term benefits ... of gross total resection and high-dose postoperative radiotherapy for the treatment of children with localized ependymoma, even for those who are younger than 3 years," Merchant said.

The study also "provides unique insight into the role of radiation therapy in the initial management of young children" and indicates "that future efforts to combat ependymoma should also prioritize increasing the rate of gross total resection."

Merchant noted that "newer methods of radiotherapy delivery promise further reductions in the dose [delivered] to
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