Treatment of patients with progression of primary cerebral ependymomas in adults

Abstract

The aim of this work is to evaluate the results of treatment of patients with progression of primary cerebral ependyma in adults. The study included 10 patients who have been hospitalized at the Chelyabinsk Regional Center for Oncology and Nuclear Medicine since 2016 to 2022. The mean age of the patients was 33.0 ± 11.21 years. In 60 % (n = 6) progression of grade 3 ependymoma was diagnosed, in 40 % (n = 4) relapse of grade 2 ependymoma was noted. All patients were female. The mean time to recurrence was 29.6 months (from 11 to 44 months). According to the method of relapse treatment, in 60 % (n = 6) of cases patients received monochemotherapy with temozolomide, 20 % (n = 2) of patients underwent stereotaxic radiotherapy on the CyberKnife device with a single focal dose (SOD) of 5.5 Gy in five fractions, before summing up the total focal dose (SOD) of 27.5 Gy, two patients underwent repeated external beam radiation therapy in the traditional mode of fractionation with SOD 40 Gy. The median overall survival (OS) for all patients was 48 months. Indicators of 1-year OR were 100 %, 2-year – 83.3 %, 3-year – 50 %. The median progression-free survival was 20 months. In the neurological status after the completion of the special treatment, a decrease in motor deficit and one aphatic disorder was noted.