Anaplastic ependymomas in children: is there any progress in treatment outcomes? Literature survey and own data

The question of the effect of the irradiation technique on the effectiveness of treatment for anaplastic ependymomas in children and adolescents remains insufficiently studied. We analyzed the overall survival in 150 such patients, 25 of them received initial radiation therapy (RT) according to the conventional method, 94 - according to the conformal method; in other patients, RT was delayed for various reasons. We carried out a single-factor and multifactorial analysis of the various causes of the success or failure of antitumor treatment. It turned out that the risk of recurrence of anaplastic ependymoma was significantly influenced by two factors of primary treatment: the radicalism of the operation and the method of RT. According to multivariate analysis, in patients receiving conventional RT on a gamma device, or initially not receiving radiation therapy, the risk of relapse is 1.7 times higher than in patients receiving conformal treatment on a linear accelerator ( P = 0.003). We have built a model of statistical prediction of relapses based on a number of factors, with a sensitivity of 75% and a specificity of 70%.