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Purpose <p>To evaluate progression-free survival (PFS), overall survival (OS), local control (LC), and radiotherapy-related toxicities in the treatment of adult intracranial ependymoma.</p> Methods <p>A retrospective analysis was performed of WHO grade 2–3 adult intracranial ependymoma patients (≥ 18 years) treated with surgery alone or surgery and adjuvant radiotherapy between 2000 and 2024. Kaplan-Meier analyses were used to estimate PFS and OS. Acute and late treatment-related toxicities were characterized.</p> Results <p>Fifty-eight patients met the inclusion criteria. Median age was 39 years (interquartile range [IQR] 25–51), and median follow-up was 51 months (IQR 23–103). Overall, 76% were WHO grade 2, 74% had posterior fossa location, gross total resection was achieved in 60%, 88% received adjuvant local radiotherapy, and 5% received adjuvant chemotherapy. Five and 10-year PFS rates were 80% and 64%, respectively; 5 and 10-year OS rates were 92% and 85%, respectively. There were 13 (22%) recurrences: The location of first failure was local in nine, distant in two, and both local and distant in two. The 5-year LC rate was 82% (95% CI 67–90%), and the 10-year LC rate was 72% (95% CI 53–84%). The median time to local failure was 5.4 years. Ten (22%) patients experienced at least one grade ≥ 2 late treatment-related toxicity. One potential secondary glioma (grade 5) occurred after nine years.</p> Conclusion <p>In adult patients with intracranial ependymomas, surgery alone or surgery followed by radiotherapy resulted in relatively favorable long-term PFS, OS, and LC. Recurrences and late toxicities remain a concern.</p>

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Long-term outcomes and late effects of surgery and radiotherapy in adult intracranial ependymoma patients

  • 期刊论文

  • 发表日期：

    2026年6月25日

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  • Olaf N. van de Langerijt,
  • Felix Ehret,
  • Andrzej Niemierko,
  • Kevin S. Oh,
  • William E. Butler,
  • William T. Curry,
  • Brian V. Nahed,
  • Daphne A. Haas-Kogan,
  • Nirav Patel,
  • Ariel E. Marciscano,
  • Rifaquat M. Rahman,
  • Geert O. Janssens,
  • Helen A. Shih

摘要

Purpose

To evaluate progression-free survival (PFS), overall survival (OS), local control (LC), and radiotherapy-related toxicities in the treatment of adult intracranial ependymoma.

Methods

A retrospective analysis was performed of WHO grade 2–3 adult intracranial ependymoma patients (≥ 18 years) treated with surgery alone or surgery and adjuvant radiotherapy between 2000 and 2024. Kaplan-Meier analyses were used to estimate PFS and OS. Acute and late treatment-related toxicities were characterized.

Results

Fifty-eight patients met the inclusion criteria. Median age was 39 years (interquartile range [IQR] 25–51), and median follow-up was 51 months (IQR 23–103). Overall, 76% were WHO grade 2, 74% had posterior fossa location, gross total resection was achieved in 60%, 88% received adjuvant local radiotherapy, and 5% received adjuvant chemotherapy. Five and 10-year PFS rates were 80% and 64%, respectively; 5 and 10-year OS rates were 92% and 85%, respectively. There were 13 (22%) recurrences: The location of first failure was local in nine, distant in two, and both local and distant in two. The 5-year LC rate was 82% (95% CI 67–90%), and the 10-year LC rate was 72% (95% CI 53–84%). The median time to local failure was 5.4 years. Ten (22%) patients experienced at least one grade ≥ 2 late treatment-related toxicity. One potential secondary glioma (grade 5) occurred after nine years.

Conclusion

In adult patients with intracranial ependymomas, surgery alone or surgery followed by radiotherapy resulted in relatively favorable long-term PFS, OS, and LC. Recurrences and late toxicities remain a concern.