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1. Chamberlain MC: Salvage chemotherapy for recurrent spinal cord ependymona. Cancer; 2002 Sep 1;95(5):997-1002
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Salvage chemotherapy for recurrent spinal cord ependymona.
  • BACKGROUND: Ependymomas are reported to constitute 4% of all primary central nervous system (CNS) malignancies in adults, 30% of which occur in the spinal cord.
  • A prospective Phase II study to determine toxicity and response to chronic oral etoposide in patients with recurrent low-grade intramedullary spinal cord ependymoma (SCE) was conducted.
  • METHODS: Ten patients (6 males and 4 females with a median age of 30 years) with recurrent SCE were treated with oral etoposide (50mg/m(2)/day given daily for 21 days followed by a 14-day break and then repeated constituted a cycle of therapy).
  • All patients had failed surgery and radiotherapy and four patients had failed one prior chemotherapy.
  • Contrast-enhanced magnetic resonance imaging of the spine was performed every 8 weeks after a cycle of etoposide and before the next cycle of chemotherapy was initiated.
  • RESULTS: Treatment-related complications included alopecia in 9 patients, nonbloody diarrhea in 6 patients, a baseline weight loss of > 10% in 5 patients, Grade (according to the National Cancer Institute Common Toxicity Scale) 3-4 neutropenia in 3 patients, Grade 3-4 thrombocytopenia in 3 patients, and Grade 3-4 anemia in 2 patients.
  • There were no treatment-related deaths reported.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / pharmacology. Ependymoma / drug therapy. Etoposide / pharmacology. Neoplasm Recurrence, Local / drug therapy. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Administration, Oral. Adult. Alopecia / chemically induced. Disease-Free Survival. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Salvage Therapy. Thrombocytopenia / chemically induced. Treatment Outcome. Weight Loss

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  • [Copyright] Copyright 2002 American Cancer Society.
  • (PMID = 12209682.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide
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2. Merchant TE, Pollack IF, Loeffler JS: Brain tumors across the age spectrum: biology, therapy, and late effects. Semin Radiat Oncol; 2010 Jan;20(1):58-66
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  • [Title] Brain tumors across the age spectrum: biology, therapy, and late effects.
  • Compared with adults, pediatric tumor types (mostly glial and neuronal) are more sensitive to adjuvant irradiation and chemotherapy.
  • The spectrum of side effects is broader in the child based on age and extent of treatment: radiation therapy brings increased risk of severe long-term sequelae affecting neurologic, endocrine, and cognitive function.
  • In this review of glioma, ependymoma, and medulloblastoma, we highlight the differences between adults and children, including the higher incidence of spinal cord ependymoma and supratentorial high-grade glioma in the adult and a higher incidence of medulloblastoma in the child.
  • With the exception of completely resected low-grade glioma, radiation therapy remains a standard of care for most patients.
  • In some settings, the radiation oncologist should suggest further surgery or additional adjuvant therapy in an effort to optimize local tumor control.
  • An effort is underway to better characterize adult and pediatric brain tumors biologically with an emphasis on improving our understanding of tumor genesis, malignant transformation, and some of the similarities and differences between tumor types and their response to conventional therapy.
  • [MeSH-major] Brain Neoplasms / epidemiology. Brain Neoplasms / therapy. Glioma / epidemiology. Glioma / therapy. Radiotherapy / adverse effects
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Child. Child, Preschool. Combined Modality Therapy / methods. Disease Progression. Ependymoma / epidemiology. Ependymoma / therapy. Humans. Incidence. Infant. Infant, Newborn. Medulloblastoma / epidemiology. Medulloblastoma / therapy. Radiation Injuries. Young Adult

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  • (PMID = 19959032.001).
  • [ISSN] 1532-9461
  • [Journal-full-title] Seminars in radiation oncology
  • [ISO-abbreviation] Semin Radiat Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 40
  • [Other-IDs] NLM/ NIHMS425593; NLM/ PMC3529408
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3. Taricco MA, Guirado VM, Fontes RB, Plese JP: Surgical treatment of primary intramedullary spinal cord tumors in adult patients. Arq Neuropsiquiatr; 2008 Mar;66(1):59-63
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  • [Title] Surgical treatment of primary intramedullary spinal cord tumors in adult patients.
  • BACKGROUND: Primary spinal cord intramedullary tumors are rare and present with insidious symptoms.
  • Previous treatment protocols emphasized biopsy and radiation/chemotherapy but more aggressive protocols have emerged.
  • The cervical cord was involved in 27% and thoracic in 42% of patients.
  • Ependymoma was the most frequent tumor (66.7%).
  • [MeSH-major] Cervical Vertebrae. Spinal Cord Neoplasms / surgery. Thoracic Vertebrae
  • [MeSH-minor] Adult. Female. Humans. Male. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 18392416.001).
  • [ISSN] 0004-282X
  • [Journal-full-title] Arquivos de neuro-psiquiatria
  • [ISO-abbreviation] Arq Neuropsiquiatr
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Brazil
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4. Bouffet E, Capra M, Bartels U: Salvage chemotherapy for metastatic and recurrent ependymoma of childhood. Childs Nerv Syst; 2009 Oct;25(10):1293-301
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  • [Title] Salvage chemotherapy for metastatic and recurrent ependymoma of childhood.
  • INTRODUCTION: Chemotherapy has limited role in the up-front management of ependymoma.
  • At the time of recurrence, the role of chemotherapy is also ill defined and the choice of chemotherapeutic agents is often arbitrary, based on anecdotal data and personal experience.
  • METHODS: The purpose of this review is to describe and critically analyze the published literature on chemotherapy in patients with recurrent and metastatic ependymoma.
  • DISCUSSION: The disappointing response rate with single agents (12.9%) and combinations (17.4%) emphasizes the need to re-evaluate the current chemotherapeutic approach of intracranial ependymoma, and biological studies are needed to identify targets that may be considered for clinical trials.
  • [MeSH-major] Ependymoma / drug therapy. Neoplasm Metastasis / drug therapy. Neoplasm Recurrence, Local / drug therapy. Salvage Therapy / methods
  • [MeSH-minor] Brain Neoplasms / drug therapy. Child. Humans. Spinal Cord Neoplasms / drug therapy

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  • (PMID = 19360417.001).
  • [ISSN] 1433-0350
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 85
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5. Lin YH, Huang CI, Wong TT, Chen MH, Shiau CY, Wang LW, Ming-Tak Ho D, Yen SH: Treatment of spinal cord ependymomas by surgery with or without postoperative radiotherapy. J Neurooncol; 2005 Jan;71(2):205-10

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of spinal cord ependymomas by surgery with or without postoperative radiotherapy.
  • PURPOSE: To evaluate the effectiveness of complete resection and postoperative radiotherapy in spinal cord ependymomas.
  • METHODS AND MATERIALS: We conducted a retrospective study over 20 patients (13 males and 7 females) with histologically confirmed spinal cord ependymomas between July 1985 and April 2001.
  • Among them, 13 patients had ependymomas, 6 had myxopapillary ependymomas, and 1 had anaplastic ependymoma.
  • All patients received radical surgery for tumor removal with 13 patients achieving complete resection and 7 incomplete resection due to technical difficulty.
  • Among those with incomplete resection, 6 patients received postoperative radiotherapy to tumor bed and only one patient with anaplastic ependymoma received surgery alone.
  • The total tumor dose ranged from 50 to 60 Gy.
  • The median survival time of all patients was 109 months, with 104 months in the complete resection alone group and 135 months in the incomplete resection with postoperative radiotherapy group.
  • One patient with anaplastic ependymoma and no postoperative radiotherapy developed leptomeningeal seeding 9 months after surgery.
  • Salvage therapy of radiotherapy and chemotherapy maintained normal neurological functions.
  • The patient expired 34 months from the initial diagnosis due to progression of leptomeningeal seeding.
  • CONCLUSION: Complete resection alone in spinal cord ependymoma can achieve excellent local control and survival.
  • Local radiotherapy with 50-60 Gy is effective and safe.
  • [MeSH-major] Ependymoma / radiotherapy. Ependymoma / surgery. Spinal Cord Neoplasms / radiotherapy. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Child. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / therapy. Nervous System / physiopathology. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 15690140.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Benesch M, Weber-Mzell D, Gerber NU, von Hoff K, Deinlein F, Krauss J, Warmuth-Metz M, Kortmann RD, Pietsch T, Driever PH, Quehenberger F, Urban C, Rutkowski S: Ependymoma of the spinal cord in children and adolescents: a retrospective series from the HIT database. J Neurosurg Pediatr; 2010 Aug;6(2):137-44
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  • [Title] Ependymoma of the spinal cord in children and adolescents: a retrospective series from the HIT database.
  • OBJECT: Reports on spinal cord ependymoma in children are rare.
  • The aim of this study was to evaluate the clinical spectrum, treatment, and outcome of children with primary ependymoma of the spinal cord who were registered in the database of the pediatric German brain tumor studies Hirntumor (HIT) '91 and HIT 2000.
  • METHODS: Between 1991 and 2007, 29 patients (12 male and 17 female, median age at diagnosis 13.6 years) with primary spinal cord ependymoma (myxopapillary ependymoma WHO Grade I, II, and III tumors in 6, 17, and 6 patients, respectively) were identified.
  • Four patients had neurofibromatosis Type 2.
  • Seven patients (24.1%) developed progressive disease or relapse, 2 after gross-total resection (GTR) and 5 after incomplete resection or biopsy.
  • One patient with anaplastic ependymoma (WHO Grade III) died 65 months after diagnosis of disease progression.
  • Primary adjuvant treatment (radiotherapy, chemotherapy, or both) was used in 8 (50%) of 16 patients following GTR and in 9 (82%) of 11 patients who underwent less than a GTR.
  • A high relapse incidence (4 of 6) was observed among patients with myxopapillary ependymoma.
  • CONCLUSIONS: Gross-total resection is the mainstay of treatment for patients with primary spinal cord ependymoma and may be achieved in about 50% of the patients using modern surgical techniques.
  • Primary adjuvant treatment was commonly used in children with spinal cord ependymoma irrespective of the extent of resection or tumor grade.
  • The impact of adjuvant treatment on progression-free and overall survival has to be investigated in a prospective trial.
  • [MeSH-major] Ependymoma / surgery. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Adolescent. Austria. Biopsy. Chemotherapy, Adjuvant. Child. Combined Modality Therapy. Disability Evaluation. Disease Progression. Female. Follow-Up Studies. Germany. Humans. Male. Neurofibromatosis 2 / diagnosis. Neurofibromatosis 2 / drug therapy. Neurofibromatosis 2 / pathology. Neurofibromatosis 2 / radiotherapy. Neurofibromatosis 2 / surgery. Postoperative Complications / diagnosis. Postoperative Complications / mortality. Prospective Studies. Radiotherapy, Adjuvant. Registries. Survival Rate

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  • (PMID = 20672934.001).
  • [ISSN] 1933-0715
  • [Journal-full-title] Journal of neurosurgery. Pediatrics
  • [ISO-abbreviation] J Neurosurg Pediatr
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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7. Santamato A, Panza F, Ranieri M, Amoruso MT, Amoruso L, Frisardi V, Solfrizzi V, Fiore P: Effect of intrathecal baclofen, botulinum toxin type A and a rehabilitation programme on locomotor function after spinal cord injury: a case report. J Rehabil Med; 2010 Oct;42(9):891-4
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  • [Title] Effect of intrathecal baclofen, botulinum toxin type A and a rehabilitation programme on locomotor function after spinal cord injury: a case report.
  • OBJECTIVE: A few studies have reported the use of botulinum toxin injections after spinal cord injury, as this is the gold standard to treat focal spasticity.
  • CASE REPORT: A 38-year-old woman who had become paraplegic and care-dependent secondary to cervico-thoracic intramedullary ependymoma, presented 8 months later with painful lower limb spasticity, which was being treated with oral anti-spastic and benzodiazepine drugs with no therapeutic effect.
  • Therefore, she was also treated with bilateral injections of botulinum toxin type A into the flexor digitorum brevis muscles.
  • CONCLUSION: The use of botulinum toxin type A may be an important adjunctive therapy to increase the therapeutic effect of baclofen on spasticity in small muscles, resulting in a more focal effect, and improving the use of orthoses and the effectiveness of rehabilitation programmes in patients after spinal cord injury.
  • [MeSH-major] Baclofen / administration & dosage. Botulinum Toxins, Type A / administration & dosage. Neuromuscular Agents / administration & dosage. Spinal Cord Injuries / drug therapy
  • [MeSH-minor] Adult. Drug Therapy, Combination. Ependymoma / complications. Female. Gait. Humans. Injections, Intramuscular. Injections, Spinal. Muscle Relaxants, Central / administration & dosage. Muscle Spasticity / drug therapy. Spinal Neoplasms / complications. Treatment Outcome

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  • (PMID = 20878052.001).
  • [ISSN] 1651-2081
  • [Journal-full-title] Journal of rehabilitation medicine
  • [ISO-abbreviation] J Rehabil Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Sweden
  • [Chemical-registry-number] 0 / Muscle Relaxants, Central; 0 / Neuromuscular Agents; EC 3.4.24.69 / Botulinum Toxins, Type A; H789N3FKE8 / Baclofen
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8. Morgan RJ, Synold T, Mamelak A, Lim D, Al-Kadhimi Z, Twardowski P, Leong L, Chow W, Margolin K, Shibata S, Somlo G, Yen Y, Frankel P, Doroshow JH: Plasma and cerebrospinal fluid pharmacokinetics of topotecan in a phase I trial of topotecan, tamoxifen, and carboplatin, in the treatment of recurrent or refractory brain or spinal cord tumors. Cancer Chemother Pharmacol; 2010 Oct;66(5):927-33
Hazardous Substances Data Bank. CARBOPLATIN .

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  • [Title] Plasma and cerebrospinal fluid pharmacokinetics of topotecan in a phase I trial of topotecan, tamoxifen, and carboplatin, in the treatment of recurrent or refractory brain or spinal cord tumors.
  • RESULTS: Seventeen patients received 39 cycles of treatment: median 2, (range 1-5).
  • The tumors included glioblastoma (6), anaplastic astrocytoma (2), metastatic non-small cell (3), small cell lung (2), and one each with medulloblastoma, ependymoma, and metastatic breast or colon carcinoma.

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  • (PMID = 20107803.001).
  • [ISSN] 1432-0843
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA033572; United States / NCI NIH HHS / CA / P30 CA033572-26; United States / NCI NIH HHS / CA / CA 33572
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 094ZI81Y45 / Tamoxifen; 7M7YKX2N15 / Topotecan; BG3F62OND5 / Carboplatin
  • [Other-IDs] NLM/ NIHMS335377; NLM/ PMC3265324
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9. Reni M, Gatta G, Mazza E, Vecht C: Ependymoma. Crit Rev Oncol Hematol; 2007 Jul;63(1):81-9
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  • [Title] Ependymoma.
  • Ependymomas are rare tumours of neuroectodermal origin classified as myxopapillary ependymoma and subependymoma (grade I), ependymoma (grade II) and anaplastic ependymoma (grade III).
  • Age <40 years and extent of surgery appear related to better prognosis, while the role of other prognostic factors, such as tumour grade and tumour site are equivocal.
  • This emphasizes the role of surgery as the standard treatment.
  • Recommended dose to involved fields is 45-54 Gy for low-grade (grade II) and 54-60 Gy for high-grade ependymomas (grade III).
  • There is no proof that postoperative chemotherapy improves the outcome.
  • At recurrence, platinum-, nitrosourea- or temozolomide-based chemotherapy can be administered, although there is no evidence of efficacy.
  • [MeSH-major] Brain Neoplasms / pathology. Ependymoma / pathology. Infratentorial Neoplasms / pathology. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Age Distribution. Female. Glial Fibrillary Acidic Protein / metabolism. Humans. Incidence. Male. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Risk Factors. Sex Factors. Survival Analysis

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  • (PMID = 17482475.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Glial Fibrillary Acidic Protein
  • [Number-of-references] 100
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10. Thorarinsdottir HK, Rood B, Kamani N, Lafond D, Perez-Albuerne E, Loechelt B, Packer RJ, MacDonald TJ: Outcome for children &lt;4 years of age with malignant central nervous system tumors treated with high-dose chemotherapy and autologous stem cell rescue. Pediatr Blood Cancer; 2007 Mar;48(3):278-84
Hazardous Substances Data Bank. VINCRISTINE .

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  • [Title] Outcome for children <4 years of age with malignant central nervous system tumors treated with high-dose chemotherapy and autologous stem cell rescue.
  • In an attempt to delay or obviate radiation therapy (XRT) and improve outcome, our institution has treated children <4 yo with newly diagnosed malignant CNS tumors with high-dose chemotherapy (HDC) and autologous stem cell rescue (ASCR) followed by selective XRT.
  • PROCEDURE: Fifteen children (age 4-38 months) with malignant CNS tumors have completed treatment with HDC/ASCR.
  • All patients received three cycles of induction chemotherapy (cisplatin 3.5 mg/kg- day 0, cyclophosphamide 60 mg/kg- day 1 and 2, etoposide 2.5 mg/kg- day 0-2, vincristine 0.05 mg/kg, day 0, 7, 14) followed by three cycles of HDC (carboplatin 17 mg/kg and thiotepa 6 mg/kg, day 0 and 1) with ASCR.
  • Histology included five medulloblastomas, four primitive neuroectodermal tumors (PNET), five malignant gliomas, and one ependymoma.
  • Outcome and treatment toxicities were evaluated by retrospective chart review.
  • RESULTS: Median follow-up time of the 15 patients is 22 months (range 8-82 months).
  • There was no treatment mortality.
  • The treatment regimen is relatively well tolerated.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Oligodendroglioma / therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Carboplatin / administration & dosage. Child, Preschool. Cisplatin / administration & dosage. Cognition Disorders / etiology. Cranial Irradiation / adverse effects. Cyclophosphamide / administration & dosage. Developmental Disabilities / etiology. Disease-Free Survival. Ependymoma / drug therapy. Ependymoma / mortality. Ependymoma / surgery. Etoposide / administration & dosage. Follow-Up Studies. Ganglioglioma / drug therapy. Ganglioglioma / metabolism. Ganglioglioma / radiotherapy. Ganglioglioma / surgery. Glioma / drug therapy. Glioma / mortality. Glioma / radiotherapy. Glioma / surgery. Humans. Infant. Medulloblastoma / drug therapy. Medulloblastoma / mortality. Medulloblastoma / radiotherapy. Medulloblastoma / surgery. Mitotic Index. Neuroectodermal Tumors, Primitive / drug therapy. Neuroectodermal Tumors, Primitive / mortality. Neuroectodermal Tumors, Primitive / radiotherapy. Neuroectodermal Tumors, Primitive / surgery. Quadriplegia / etiology. Retrospective Studies. Sensation Disorders / etiology. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / surgery. Thiotepa / administration & dosage. Transplantation, Autologous. Treatment Outcome. Vincristine / administration & dosage

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
  • (PMID = 16456857.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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11. Maksoud YA, Hahn YS, Engelhard HH: Intracranial ependymoma. Neurosurg Focus; 2002 Sep 15;13(3):e4
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  • [Title] Intracranial ependymoma.
  • OBJECT: An intracranial ependymoma is a relatively rare but very interesting variety of glioma.
  • In this paper, the authors compiled a review of the pathological features, imaging characteristics, and treatment strategies related to this brain tumor.
  • METHODS: A Medline search was conducted using the term "ependymoma."
  • The bibliographies of papers obtained were also checked for articles and chapters that could provide additional understanding of this tumor.
  • Malignant ependymomas and ependymomas of the spinal cord (including myxopapillary ependymomas) were excluded from this review.
  • CONCLUSIONS: The posterior fossa is the most frequent site for an intracranial ependymoma.
  • Most authors recommend resecting as much of the tumor as is safely possible.
  • Microscopically, ependymal tumors show both epithelial and glial features.
  • Because ependymomas often recur despite surgical intervention, radiotherapy and/or radiosurgery may also play an important role in their treatment.
  • The use of chemotherapy in the treatment of these tumors, especially in the very young, is still being studied.
  • [MeSH-major] Brain Neoplasms / pathology. Brain Neoplasms / surgery. Ependymoma / pathology. Ependymoma / surgery

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  • (PMID = 15844876.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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12. Fakhrai N, Neophytou P, Dieckmann K, Nemeth A, Prayer D, Hainfellner J, Marosi C: Recurrent spinal ependymoma showing partial remission under Imatimib. Acta Neurochir (Wien); 2004 Nov;146(11):1255-8
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  • [Title] Recurrent spinal ependymoma showing partial remission under Imatimib.
  • BACKGROUND: There are few treatment options for recurrent spinal ependymoma after surgery and radiation therapy.
  • CLINICAL PRESENTATION: We present a patient with recurrent spinal ependymoma who received radiation therapy after laminectomy and partial tumor resection.
  • Months later, the patient developed gait paresis.
  • MRT showed tumor recurrence and partial resection was again performed.
  • Oral cytotoxic chemotherapy with Temozolomide was initiated.
  • As the tumor had stained positively for platelet derived growth factor (PDGF) receptor, treatment with Imatimib was initiated.
  • FINDINGS: The patient experienced improvement in neurological symptoms and the following MRT revealed slight tumor regression.
  • CONCLUSION: Imatimib should be considered a potential therapeutic option in recurrent ependymomas expressing PDGF receptor.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Ependymoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Spinal Cord Neoplasms / drug therapy

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  • (PMID = 15365794.001).
  • [ISSN] 0001-6268
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Receptors, Platelet-Derived Growth Factor
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13. Shim KW, Kim DS, Choi JU: The history of ependymoma management. Childs Nerv Syst; 2009 Oct;25(10):1167-83
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  • [Title] The history of ependymoma management.
  • INTRODUCTION: The ependymomas are relatively not a common tumor.
  • However, most clinicians agree that the radical removal of the tumor is the most important prognostic factor.
  • MORBIDITY OF TREATMENT: Tumor removal was not sufficient before the era of magnetic resonance imaging (MRI) and resulted in a considerable operative morbidity and mortality.
  • As the microneurosurgical techniques and microsurgical anatomy become popular and the MRI provide more detailed anatomical information preoperatively, radical removal of this complex and complicated tumor can be more feasible.
  • In childhood ependymoma, the treatment-related morbidity and mortality can be the special issues, which can modify the policy of management safe tumor removal and minimal adjuvant treatment, which are extremely important.
  • RADIATION THERAPY: Radiation treatment has been the option for disseminated disease and residual tumor.
  • PROGNOSTIC FACTORS: Although many clinicians believe that the ependymomas are inheritably chemoresistant, the new targets for the treatment are under investigation or clinically tried.
  • Also, the genetic alterations of ependymoma are developing and might be a promising target.
  • CONCLUSION: The surgical techniques and assistant modalities for tumor removal are still advancing.
  • So, the outcome of ependymoma is still improving.
  • Unfortunately, newer treatment modalities, such as new chemotherapeutic agent and gene modification agent, are still not promising.
  • The history of ependymoma management is still in progress.
  • [MeSH-major] Ependymoma / diagnosis. Ependymoma / therapy
  • [MeSH-minor] Brain Neoplasms / diagnosis. Brain Neoplasms / mortality. Brain Neoplasms / therapy. Child. Drug Therapy / mortality. Humans. Neurosurgical Procedures / mortality. Prognosis. Radiotherapy / mortality. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / mortality. Spinal Cord Neoplasms / therapy

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  • (PMID = 19458954.001).
  • [ISSN] 1433-0350
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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14. Balmaceda C: Chemotherapy for intramedullary spinal cord tumors. J Neurooncol; 2000 May;47(3):293-307

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy for intramedullary spinal cord tumors.
  • Although surgery represents the most effective treatment, recurrence may occur.
  • As a large proportion of intramedullary malignancies occur in children, who are more sensitive to the deleterious effects of irradiation, chemotherapy assumes an important role.
  • This article describes the most common intramedullary tumors and the role of chemotherapy.
  • [MeSH-major] Astrocytoma / drug therapy. Ependymoma / drug therapy. Germinoma / drug therapy. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Adult. Child. Genetic Therapy. Humans. Neuroectodermal Tumors, Primitive / therapy. Prognosis

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  • (PMID = 11016745.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 82
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15. Akyurek S, Chang EL, Yu TK, Little D, Allen PK, McCutcheon I, Mahajan A, Maor MH, Woo SY: Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M.D. Anderson Cancer Center. J Neurooncol; 2006 Nov;80(2):177-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M.D. Anderson Cancer Center.
  • This study was undertaken to determine the disease outcomes in patients treated with surgery alone or surgery and adjuvant radiotherapy (RT) for myxopapillary ependymoma (MPE) of the spine.
  • A total of 12 (34%) patients had disease recurrence, all in the neural axis; 8 of them had treatment failure at the primary site only, 3 in the distant neural axis only, and 1 at the primary site and in the distant neural axis.
  • Regardless of the extent of resection, adjuvant RT appears to significantly reduce the rate of tumor progression.
  • [MeSH-major] Ependymoma / drug therapy. Ependymoma / radiotherapy. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Age Factors. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neurologic Examination. Prognosis. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Failure. Treatment Outcome

  • Genetic Alliance. consumer health - Ependymoma.
  • Genetic Alliance. consumer health - Myxopapillary ependymoma.
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  • (PMID = 16648988.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Kocak Z, Garipagaoglu M, Adli M, Uzal MC, Kurtman C: Spinal cord ependymomas in adults: analysis of 15 cases. J Exp Clin Cancer Res; 2004 Jun;23(2):201-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spinal cord ependymomas in adults: analysis of 15 cases.
  • This retrospective analysis was performed to examine the outcome of patients with spinal cord ependymomas treated with surgery and postoperative radiation therapy between 1982 and 1998.
  • All patients received radiation therapy with a total dose of 40-56 Gy.
  • Of the 15 patients, 6 developed recurrent disease on follow-up.
  • The median time to recurrence was 45 months (range: 24-80 months).
  • Local failure within the initial irradiated volume occurred in 3 out of 6 patients who received less than 45 Gy and 2 out of 8 patients treated with more than 45 Gy.
  • Four out of the six failures were salvaged with additional treatment.
  • Re-irradiation was used as a part of salvage or sole treatment in 3 cases.
  • The patient who was salvaged with radiation therapy only died of disease progression 41 months following recurrence and the other two who received a combination of surgery, radiotherapy or chemotherapy were still alive 57 and 30 months following relapse.
  • The present study shows that surgery and post-operative radiation treatment for spinal ependymoma patients resulted in high survival rates.
  • Patients with residual disease after surgery should be treated with radiation therapy with a dose of more than 45 Gy.
  • Re-irradiation may be the treatment of choice for recurrent patients having less than complete resection or no surgery.
  • [MeSH-major] Ependymoma / pathology. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Radiotherapy Dosage. Retrospective Studies. Salvage Therapy. Survival Rate. Treatment Outcome

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  • (PMID = 15354403.001).
  • [ISSN] 0392-9078
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 22
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17. Ma YT, Ramachandra P, Spooner D: Case report: primary subcutaneous sacrococcygeal ependymoma: a case report and review of the literature. Br J Radiol; 2006 May;79(941):445-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Case report: primary subcutaneous sacrococcygeal ependymoma: a case report and review of the literature.
  • Treatment is complete surgical resection.
  • Adjuvant radiotherapy is of benefit to those with an incompletely excised tumour.
  • Palliative chemotherapy has not been shown to be of any benefit.
  • We report a 37-year-old woman with a subcutaneous sacrococcygeal ependymoma with iliac lymph nodal metastasis at presentation.
  • [MeSH-major] Ependymoma / diagnosis. Neoplasm Recurrence, Local / diagnosis. Spinal Cord Neoplasms / diagnosis

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  • (PMID = 16632628.001).
  • [ISSN] 0007-1285
  • [Journal-full-title] The British journal of radiology
  • [ISO-abbreviation] Br J Radiol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Glial Fibrillary Acidic Protein; 0 / S100 Proteins; 0 / Vimentin
  • [Number-of-references] 12
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18. Harrop JS, Ganju A, Groff M, Bilsky M: Primary intramedullary tumors of the spinal cord. Spine (Phila Pa 1976); 2009 Oct 15;34(22 Suppl):S69-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary intramedullary tumors of the spinal cord.
  • OBJECTIVE: To define optimal clinical care for primary intramedullary spinal cord tumors using a systematic review with expert opinion.
  • METHODS: Focused questions on the treatment of primary intramedullary spinal cord tumors were refined by a panel of spine oncology surgeons, medical and radiation oncologist.
  • These treatment recommendations were then rated as either strong or weak based on the quality of evidence and clinical expertise.
  • The subsequent search resulted in a return of: "spinal cord tumor" (5053), "ependymoma" (580), "astrocytoma" (420), and "glioma" (235) articles.
  • Seventeen articles referenced timing of surgical intervention and symptomatology for intramedullary spinal cord tumors.
  • One hundred fifty-eight chemotherapy and 183 radiation therapy articles for intramedullary spinal cord tumors were reviewed.
  • However, this must be taken in the context of the underlying tumor histology.
  • Adjuvant therapy is an option for high grade astrocytomas (WHO grades 3-4).
  • [MeSH-major] Glioma / radiotherapy. Glioma / surgery. Spinal Cord Neoplasms / radiotherapy. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Humans. Radiotherapy, Adjuvant. Severity of Illness Index. Treatment Outcome

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  • (PMID = 19829279.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 75
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19. Kothbauer KF: Neurosurgical management of intramedullary spinal cord tumors in children. Pediatr Neurosurg; 2007;43(3):222-35

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neurosurgical management of intramedullary spinal cord tumors in children.
  • The majority of intramedullary spinal cord tumors in children are low-grade glial tumors.
  • They become symptomatic with pain, neurologic deficits or spinal deformity.
  • The diagnosis is most readily obtained using magnetic resonance imaging.
  • Surgery is the best treatment and is also indicated to confirm the histological diagnosis.
  • In case of a low-grade tumor or a vascular lesion such as hemangioblastoma or cavernoma, a total or near-total resection is attempted.
  • High-grade tumors are resected conservatively and treated with radiation and chemotherapy.
  • [MeSH-major] Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Astrocytoma / diagnosis. Astrocytoma / mortality. Astrocytoma / surgery. Child. Disease-Free Survival. Ependymoma / diagnosis. Ependymoma / mortality. Ependymoma / surgery. Follow-Up Studies. Ganglioglioma / diagnosis. Ganglioglioma / mortality. Ganglioglioma / surgery. Hemangioblastoma / diagnosis. Hemangioblastoma / mortality. Hemangioblastoma / surgery. Humans. Magnetic Resonance Imaging. Monitoring, Intraoperative. Postoperative Complications / diagnosis. Postoperative Complications / etiology. Prognosis

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  • (PMID = 17409792.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 98
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20. Mohammadianpanah M, Vasei M, Mosalaei A, Omidvari S, Ahmadloo N: Malignant spinal cord compression in cancer patients may be mimicked by a primary spinal cord tumour. Eur J Cancer Care (Engl); 2006 Dec;15(5):497-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant spinal cord compression in cancer patients may be mimicked by a primary spinal cord tumour.
  • Although it is quite rare, second primary neoplasms in cancer patients may present with the signs and symptoms of malignant spinal cord compression.
  • Primary spinal cord tumours in the cancer patients may be deceptive and considered as the recurrent first cancer.
  • We report such a case of intramedullary ependymoma of the cervical spinal cord mimicking metatstatic recurrent lymphoma and causing cord compression.
  • A 50-year-old man developed intramedullary ependymoma of the cervical spinal cord 1.5 years following chemoradiation for Waldeyer's ring lymphoma.
  • Magnetic resonance imaging revealed an intramedullary expansive lesion extending from C4 to C6 levels of the cervical spinal cord.
  • He underwent operation, and the tumour was subtotally resected.
  • The development of the intramedullary ependymoma following treating lymphoma has not been reported.
  • [MeSH-major] Ependymoma / diagnosis. Neoplasms, Second Primary / diagnosis. Spinal Cord Compression / etiology. Spinal Cord Neoplasms / diagnosis
  • [MeSH-minor] Cervical Vertebrae. Diagnosis, Differential. Humans. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / radiotherapy. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local / diagnosis. Oropharyngeal Neoplasms / drug therapy. Oropharyngeal Neoplasms / radiotherapy. Quadriplegia / etiology

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  • (PMID = 17177910.001).
  • [ISSN] 0961-5423
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 10
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21. Castadot P, Magné N, Roelandts M, Gastelblum P, Oulad Ben Taib N, Van Houtte P: [Metastasis of a lumbosacral ependymoma with very long disease-free survival: a case report and review of the literature]. Cancer Radiother; 2006 May;10(3):148-51
Genetic Alliance. consumer health - Ependymoma.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Metastasis of a lumbosacral ependymoma with very long disease-free survival: a case report and review of the literature].
  • [Transliterated title] Métastase d'un épendymome lombosacré avec très long intervalle libre: cas clinique et revue de la littérature.
  • Ependymoma is rare glial tumour of the central nervous system and is considered to be low-grade.
  • The lumbosacral location of spinal ependymoma is the most common.
  • Prognosis of ependymomas is dependent on tumour location, histological subtype and differentiation, extent of the tumour and of the completeness of the surgical resection.
  • One of the characteristics of this kind of tumour is to present the possibility of a seeding of the entire cerebrospinal axis, by the way of cerebrospinal liquid.
  • We describe the case of a young male patient operated by incomplete resection of a lumbar ependymoma.
  • Six months later, the patient's symptoms reappeared and an external radiotherapy at curative doses and chemotherapy were delivered.
  • Evolution of the remaining tumour was diagnosed 6 years after at the primary site and operated by large incomplete resection.
  • Complete imaging study concluded to a cervical extramedullary intradural tumour and to the persistence of the primary lumbosacral tumour.
  • Macroscopical complete resection of the cervical tumour was performed and pathological findings concluded to a metastasis of his lumbar ependymoma.
  • External radiotherapy was delivered on this site with a total dose of 50 Gy.
  • The primary lumbosacral ependymoma is stable.
  • Awareness of such aberrant tumoral behaviour, even after such a long disease free interval, may warrant more careful follow-up of patients with this diagnosis.
  • [MeSH-major] Ependymoma / therapy. Neoplasm Recurrence, Local / therapy. Spinal Cord Neoplasms / rehabilitation
  • [MeSH-minor] Adolescent. Cervical Vertebrae. Disease-Free Survival. Humans. Lumbar Vertebrae. Male. Sacrum. Time Factors

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  • (PMID = 16581282.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 25
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22. Nishio S, Morioka T, Fujii K, Inamura T, Fukui M: Spinal cord gliomas: management and outcome with reference to adjuvant therapy. J Clin Neurosci; 2000 Jan;7(1):20-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spinal cord gliomas: management and outcome with reference to adjuvant therapy.
  • The authors review their experience with 19 consecutive cases with either astrocytic tumour (glioblastoma multiforme one, anaplastic astrocytoma one, astrocytoma 4, pilocytic astrocytoma 4) or ependymoma (10 tumours in 9 patients) of the spinal cord who were treated during the period from 1982 to 1996.
  • The main tumour locations included the cervicomedullary region 5 the cervical cord (8), the thoracic cord (5) and one each in the thoracolumbar region and conus medullaris.
  • While a total removal of the tumour was achieved in 8 out of 10 ependymomas, the initial treatment for astrocytic tumours was a partial resection in 5, and biopsy in the remaining 5.
  • As adjuvant treatment, 8 patients received radiation therapy and 2 received chemotherapy.
  • Two patients with an astrocytic tumour received chemotherapy only, while the remaining 9 received neither radiation therapy nor chemotherapy initially.
  • After these treatments, 6 out of the 8 patients with low grade astrocytoma have remained alive for 1.3-12.6 years, while 2 patients with high grade astrocytic tumours died within 15 months following surgery.
  • Eight out of 9 patients with an ependymoma have remained alive for 3.0-12.3 years, while one committed suicide 2 years after surgery.
  • The postoperative results and the rationale for surgery is discussed, and an approach for utilising adjuvant therapy for high grade tumours is also suggested.
  • [MeSH-major] Astrocytoma / surgery. Ependymoma / surgery. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Child, Preschool. Female. Glioblastoma / drug therapy. Glioblastoma / radiotherapy. Glioblastoma / surgery. Humans. Infant. Male. Middle Aged. Postoperative Care. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 10847645.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] SCOTLAND
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23. Tekkök IH, Sav A: Aggressive spinal germinoma with ascending metastases. J Neurooncol; 2005 Nov;75(2):135-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Aggressive spinal germinoma with ascending metastases.
  • Initial spinal MR scans showed a sausage-like lesion that extended between L1 and S2.
  • At surgery, an encapsulated intradural extramedullary tumor was removed en bloc.
  • The initial histopathological diagnosis was ependymoma.
  • The tumor recurred locally to double its original size only 4 months later.
  • After second surgery, 5,100 cGy of local spinal radiation was given since the pathologist believed that the new tumor exhibited anaplastic features.
  • Subsequently tumor recurred at T6-10 levels and later in the right parasellar region.
  • At 11 months after the initial presentation, a new tumor was diagnosed at T11-T12 levels.
  • After fifth surgery, chemotherapy with cisplatin, doxorubicin and vincristine was started.
  • The new and correct histological diagnosis was germinoma.
  • A new chemotherapy regimen targeted for germinoma was then started.
  • Primary spinal germinomas are exceedingly rare.
  • A review of the literature revealed only 14 biopsy-proven spinal germinoma cases.
  • Our case is clearly unique in aggressivity of the tumor, a feature often unexpected for germinomas.
  • This case proves that the dissemination risk may be very serious for germinomas and that the craniospinal radiation may be a more secure treatment mode.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / pathology. Neoplasm Recurrence, Local / diagnosis. Reoperation. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Diagnosis, Differential. Ependymoma / diagnosis. Follow-Up Studies. Humans. Lumbar Vertebrae / anatomy & histology. Magnetic Resonance Imaging. Male. Sacrum / anatomy & histology. Time Factors. Treatment Outcome

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  • (PMID = 16132516.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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24. Engelhard HH, Villano JL, Porter KR, Stewart AK, Barua M, Barker FG, Newton HB: Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina. J Neurosurg Spine; 2010 Jul;13(1):67-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina.
  • OBJECT Patients having a primary tumor of the spinal cord, spinal meninges or cauda equina, are relatively rare.
  • Neurosurgeons encounter and treat such patients, and need to be aware of their clinical presentation, tumor types, treatment options, and potential complications.
  • METHODS Extensive information on individuals diagnosed (in the year 2000) as having a primary CNS neoplasm was prospectively collected in a Patient Care Evaluation Study conducted by the Commission on Cancer of the American College of Surgeons.
  • Intraspinal tumor cases were identified based on ICD-O-2 topography codes C70.1, C72.0, and C72.1.
  • RESULTS Patients with primary intraspinal tumors represented 4.5% of the CNS tumor group, and had a mean age of 49.3 years.
  • Pain was the most common presenting symptom, while the most common tumor types were meningioma (24.4%), ependymoma (23.7%), and schwannoma (21.2%).
  • Radiation therapy and chemotherapy were administered to 20.3% and 5.6% of patients, respectively.
  • [MeSH-major] Cauda Equina / pathology. Meningeal Neoplasms / pathology. Meningeal Neoplasms / surgery. Peripheral Nervous System Neoplasms / pathology. Peripheral Nervous System Neoplasms / surgery. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Chi-Square Distribution. Child. Child, Preschool. Ependymoma / epidemiology. Ependymoma / pathology. Ependymoma / surgery. Female. Humans. Infant. Male. Meningioma / epidemiology. Meningioma / pathology. Meningioma / surgery. Middle Aged. Neurilemmoma / epidemiology. Neurilemmoma / pathology. Neurilemmoma / surgery. Postoperative Complications / epidemiology. Prospective Studies. Radiotherapy, Adjuvant. Registries. Risk Factors. Treatment Outcome. United States / epidemiology

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  • (PMID = 20594020.001).
  • [ISSN] 1547-5646
  • [Journal-full-title] Journal of neurosurgery. Spine
  • [ISO-abbreviation] J Neurosurg Spine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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25. Chamberlain MC: Ependymomas. Curr Neurol Neurosci Rep; 2003 May;3(3):193-9
MedlinePlus Health Information. consumer health - Childhood Brain Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Ependymomas are uncommon neoplasms of the central nervous system (CNS), and as a consequence, few randomized, clinical trials have been performed, thereby limiting treatment guidelines.
  • A review of the literature would permit the following conclusions regarding treatment.
  • The best management of newly diagnosed ependymoma entails a complete resection corroborated by postoperative contrast-enhanced magnetic resonance imaging (MRI).
  • The role of chemotherapy is uncertain and in general would be reserved for patients having previously failed surgery and radiotherapy.
  • Disease-free survival following recurrence is unusual (<15% at 5 years) and suggests intensification of initial adjuvant treatment may best prevent relapse.
  • [MeSH-major] Brain Neoplasms / therapy. Ependymoma / therapy. Spinal Cord Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / classification. Antineoplastic Agents / therapeutic use. Child. Glioma, Subependymal / diagnosis. Glioma, Subependymal / therapy. Humans. Infant. Prognosis. Recurrence

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  • (PMID = 12691623.001).
  • [ISSN] 1528-4042
  • [Journal-full-title] Current neurology and neuroscience reports
  • [ISO-abbreviation] Curr Neurol Neurosci Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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26. Combemale P, Faisant M, Azoulay-Petit C, Dupin M, Kanitakis J: Neutrophilic eccrine hidradenitis secondary to infection with Serratia marcescens. Br J Dermatol; 2000 Apr;142(4):784-8
Hazardous Substances Data Bank. CIPROFLOXACIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Neutrophilic eccrine hidradenitis (NEH) is a rare dermatosis which usually develops after administration of chemotherapeutic treatments.
  • We report a patient, previously operated on for ependymoma, who presented with an eruption typical of NEH even though he had not received chemotherapy.
  • The dermatosis improved after antibiotic therapy but recurred twice and culture again isolated S. marcescens; electron microscopy revealed cytoplasmic inclusions within neutrophils, suggestive of bacteria.
  • The disease improved every time with appropriate antibiotic therapy.
  • The originality of our case is the recurrence of the disease on three occasions with the same bacterium isolated on each occasion, with disease remission after antibiotic therapy.
  • This case confirms that infections may be a possible cause of NEH and underlines the necessity to search for infective agents, especially in patients immunocompromised by haematopoietic malignancies and/or chemotherapeutic treatments.
  • [MeSH-minor] Adult. Anti-Infective Agents / therapeutic use. Ciprofloxacin / therapeutic use. Ependymoma / surgery. Humans. Male. Postoperative Complications / etiology. Recurrence. Spinal Cord Neoplasms / surgery

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  • (PMID = 10792233.001).
  • [ISSN] 0007-0963
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Anti-Infective Agents; 5E8K9I0O4U / Ciprofloxacin
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27. Hurwitz CA, Strauss LC, Kepner J, Kretschmar C, Harris MB, Friedman H, Kun L, Kadota R: Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study. J Pediatr Hematol Oncol; 2001 Jun-Jul;23(5):277-81
Hazardous Substances Data Bank. DEXAMETHASONE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Paclitaxel for the treatment of progressive or recurrent childhood brain tumors: a pediatric oncology phase II study.
  • Tumor histologic strata included: astrocytoma (n = 4), malignant glioma (n = 13), medulloblastoma (n = 16), brain stem glioma (n = 15), ependymoma (n = 13), and miscellaneous histologies (n = 12).
  • All patients had previous histologic confirmation of a primary intracranial or spinal cord tumor with magnetic resonance imaging or computed tomography documentation of unequivocally measurable progressive or recurrent disease.
  • All patients had received previous therapy including surgery, radiation therapy, and/or chemotherapy, but no patient had been previously treated on more than one phase II trial.
  • Patients were allowed to continue therapy for a total of 18 cycles in the absence of progressive disease or unacceptable toxicity.
  • RESULTS: Seventy-five patients were enrolled onto the POG 9330 protocol; two ineligible patients were removed from the study before receiving any therapy.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Brain Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adolescent. Astrocytoma / drug therapy. Astrocytoma / pathology. Child. Child, Preschool. Dexamethasone / therapeutic use. Disease Progression. Drug Hypersensitivity / prevention & control. Ependymoma / drug therapy. Ependymoma / pathology. Female. Glioma / drug therapy. Glioma / pathology. Humans. Immunosuppressive Agents / therapeutic use. Infant. Infratentorial Neoplasms / drug therapy. Infratentorial Neoplasms / pathology. Infusions, Intravenous. Male. Medulloblastoma / drug therapy. Medulloblastoma / pathology. Nausea / chemically induced. Neoplasm Recurrence, Local. Neutropenia / chemically induced. Remission Induction. Salvage Therapy. Treatment Failure

  • MedlinePlus Health Information. consumer health - Brain Tumors.
  • MedlinePlus Health Information. consumer health - Childhood Brain Tumors.
  • Hazardous Substances Data Bank. TAXOL .
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  • (PMID = 11464982.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA03161; United States / NCI NIH HHS / CA / CA07431; United States / NCI NIH HHS / CA / CA15525; etc
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Immunosuppressive Agents; 7S5I7G3JQL / Dexamethasone; P88XT4IS4D / Paclitaxel
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28. Rudà R, Gilbert M, Soffietti R: Ependymomas of the adult: molecular biology and treatment. Curr Opin Neurol; 2008 Dec;21(6):754-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ependymomas of the adult: molecular biology and treatment.
  • RECENT FINDINGS: Ependymomas of the adult are uncommon neoplasms of the central nervous system, and may occur either in the brain or the spinal cord.
  • Compared with intracranial ependymomas, spinal ependymomas are less frequent and exhibit a better prognosis.
  • Studies performed on genetic changes in ependymoma provide some insight into the pathogenesis and prognostic markers and yield new therapeutic targets, particularly focused on signal transduction modulators.
  • Chemotherapy is not advocated as primary treatment, and is best utilized as salvage treatment for patients failing surgery and radiotherapy.
  • Thus, the level of evidence regarding therapeutic strategies is low and universally accepted guidelines are lacking.
  • Molecular biology studies suggest some potential new therapeutic targets.
  • [MeSH-major] Ependymoma / genetics. Ependymoma / therapy. Molecular Biology / methods

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  • (PMID = 18989122.001).
  • [ISSN] 1350-7540
  • [Journal-full-title] Current opinion in neurology
  • [ISO-abbreviation] Curr. Opin. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 106
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29. Gilbert MR, Ruda R, Soffietti R: Ependymomas in adults. Curr Neurol Neurosci Rep; 2010 May;10(3):240-7
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • They occur most commonly in the spinal cord, where histopathologic evaluation is critical to differentiate the grade I myxopapillary ependymoma from the grade II ependymoma or grade III anaplastic ependymoma.
  • Treatment for all grades and types includes maximum surgical resection.
  • For myxopapillary ependymoma, complete removal while maintaining capsule integrity may be curative.
  • Some grade II ependymomas may be observed carefully after imaging confirms complete resection, but grade III tumors require adjuvant radiation treatment.
  • Radiation commonly is given to the region of tumor, except in cases in which there is imaging or cerebrospinal fluid evidence of tumor dissemination.
  • Chemotherapy has not been studied extensively, although most reports suggest only modest benefit.
  • Ongoing laboratory studies have uncovered important signal transduction pathways that may be better therapeutic targets, leading to the development of clinical trials using targeted agents.
  • [MeSH-major] Central Nervous System Neoplasms. Ependymoma

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  • (PMID = 20425040.001).
  • [ISSN] 1534-6293
  • [Journal-full-title] Current neurology and neuroscience reports
  • [ISO-abbreviation] Curr Neurol Neurosci Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 62
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30. Bagley CA, Wilson S, Kothbauer KF, Bookland MJ, Epstein F, Jallo GI: Long term outcomes following surgical resection of myxopapillary ependymomas. Neurosurg Rev; 2009 Jul;32(3):321-34; discussion 334
COS Scholar Universe. author profiles.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Myxopapillary ependymomas, a specific tumor variant of spinal cord ependymomas, occur most commonly in the lumbosacral region.
  • During the study period, 1,013 patients underwent surgery for spinal cord tumors.
  • Fifty-two of the patients had a myxopapillary ependymoma.
  • Fourteen pediatric patients were diagnosed with myxopapillary ependymoma.
  • Overall, the pediatric patients had a much more aggressive clinical course with a much higher rate of local recurrence and dissemination of the tumor within the neural axis (64% versus 32%).
  • The median time to disease recurrence was 88 months for the entire group.
  • No clear benefit for adjunctive chemotherapy, and radiation therapy was demonstrated.
  • [MeSH-major] Ependymoma / surgery. Spinal Cord Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Age Factors. Aged. Arthritis, Experimental / etiology. Arthritis, Experimental / pathology. Child. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Magnetic Resonance Imaging. Male. Middle Aged. Neurosurgical Procedures / adverse effects. Postoperative Complications / epidemiology. Postoperative Complications / pathology. Retrospective Studies. Treatment Outcome. Young Adult

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  • (PMID = 19221818.001).
  • [ISSN] 1437-2320
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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31. Setzer M, Murtagh RD, Murtagh FR, Eleraky M, Jain S, Marquardt G, Seifert V, Vrionis FD: Diffusion tensor imaging tractography in patients with intramedullary tumors: comparison with intraoperative findings and value for prediction of tumor resectability. J Neurosurg Spine; 2010 Sep;13(3):371-80
COS Scholar Universe. author profiles.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diffusion tensor imaging tractography in patients with intramedullary tumors: comparison with intraoperative findings and value for prediction of tumor resectability.
  • OBJECT: The aim of this retrospective study was to evaluate the predictive value of diffusion tensor (DT) imaging with respect to resectability of intramedullary spinal cord tumors and to determine the concordance of this method with intraoperative surgical findings.
  • METHODS: Diffusion tensor imaging was performed in 14 patients with intramedullary lesions of the spinal cord at different levels using a 3-T magnet.
  • The lesions could be classified into 3 types according to the fiber course.
  • In Type 1 (5 cases) fibers did not pass through the solid lesion.
  • In Type 2 (3 cases) some fibers crossed the lesion, but most of the lesion volume did not contain fibers.
  • In Type 3 (6 cases) the fibers were completely encased by tumor.
  • CONCLUSIONS: These preliminary data suggest that DT imaging in patients with spinal cord tumors is capable of predicting the resectability of the lesion.
  • [MeSH-major] Diffusion Tensor Imaging / methods. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / surgery. Therapy, Computer-Assisted / methods
  • [MeSH-minor] Astrocytoma / pathology. Astrocytoma / surgery. Ependymoma / pathology. Ependymoma / surgery. Female. Follow-Up Studies. Humans. Intraoperative Period. Lymphoma / pathology. Lymphoma / surgery. Male. Middle Aged. Multiple Sclerosis / pathology. Multiple Sclerosis / surgery. Neural Pathways / pathology. Observer Variation. Retrospective Studies. Spinal Cord / pathology. Spinal Cord / surgery. Treatment Outcome

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  • (PMID = 20809733.001).
  • [ISSN] 1547-5646
  • [Journal-full-title] Journal of neurosurgery. Spine
  • [ISO-abbreviation] J Neurosurg Spine
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] United States
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32. Moynihan TJ: Ependymal tumors. Curr Treat Options Oncol; 2003 Dec;4(6):517-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ependymal tumors.
  • Ependymal tumors are rare malignancies that arise from the cells that line the ventricles and central canal of the spinal cord.
  • Although they are more common in children, adults may also be effected by ependymal tumors.
  • Prognosis is dependent on tumor location, histology, especially for myxopapillary tumors that tend to occur in the lumbar spine, extent of surgical resection, and stage of disease.
  • Standard therapy consists of complete resection when feasible.
  • Patients with known residual disease may benefit from local radiation therapy, but the extent of radiation field and total dose are controversial.
  • Even in patients treated with involved field radiotherapy, most relapses occur within the original tumor bed, thus local control remains the biggest obstacle to effective therapy.
  • Chemotherapy has little impact against this tumor and has no role in the adjuvant setting, outside of a well designed clinical trial, with the possible exception of children younger than 5 years in an effort to delay radiation.
  • A minority of patients may respond to one of several chemotherapy regimens at the time of recurrence, but the impact of this therapy is limited.
  • Newer treatment strategies are needed.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Ependymoma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Emergency Medical Services. Humans. Life Style. Neoplasm Staging. Neurosurgical Procedures. Radiotherapy

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  • (PMID = 14585232.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 28
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33. Tseng HM, Kuo LT, Lien HC, Liu KL, Liu MT, Huang CY: Prolonged survival of a patient with cervical intramedullary glioblastoma multiforme treated with total resection, radiation therapy, and temozolomide. Anticancer Drugs; 2010 Nov;21(10):963-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prolonged survival of a patient with cervical intramedullary glioblastoma multiforme treated with total resection, radiation therapy, and temozolomide.
  • MRI showed an intramedullary mass lesion in the C2-C6 level, which was considered to be an ependymoma or astrocytoma.
  • Total resection of the tumor was performed at the C2-C6 level by laminoplasty with miniplate, followed by chemoradiotherapy (focal irradiation dose of 5000, at 200 cGy per fraction for over a period of 5 weeks) with concomitant temozolomide (75 mg/m2).
  • Histologic examination of the resected tumor confirmed GBM.
  • The tumor consisted of a markedly pleomorphic neoplasm measuring 4.6 cm×2.6 cm×1.7 cm and characterized by necrosis, atypical mitotic figures, and endothelial proliferation.
  • Recurrence in the cervical spine without brain GBM metastasis was identified 25 months after operation, and temozolomide chemotherapy was reinitiated; however, the tumor progressed, and the patient died 33 months after operation.
  • We suggest that, in addition to potential factors of tumor biology, multimodal treatment consisting of total resection of intramedullary GBM coupled with radiation therapy and temozolomide may have prolonged the survival of this patient.
  • [MeSH-major] Cervical Vertebrae. Dacarbazine / analogs & derivatives. Glioblastoma. Neurosurgical Procedures. Radiotherapy. Spinal Cord Neoplasms
  • [MeSH-minor] Adult. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / adverse effects. Biopsy. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease Progression. Disease-Free Survival. Fatal Outcome. Female. Humans. Magnetic Resonance Imaging

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  • (PMID = 20838208.001).
  • [ISSN] 1473-5741
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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34. Chamberlain MC: Etoposide for recurrent spinal cord ependymoma. Neurology; 2002 Apr 23;58(8):1310-1
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Etoposide for recurrent spinal cord ependymoma.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Ependymoma / drug therapy. Etoposide / therapeutic use. Neoplasm Recurrence, Local / drug therapy. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Humans. Karnofsky Performance Status. Male. Middle Aged

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  • (PMID = 11971113.001).
  • [ISSN] 0028-3878
  • [Journal-full-title] Neurology
  • [ISO-abbreviation] Neurology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide
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35. Madden JR, Fenton LZ, Weil M, Winston KR, Partington M, Foreman NK: Experience with tamoxifen/etoposide in the treatment of a child with myxopapillary ependymoma. Med Pediatr Oncol; 2001 Jul;37(1):67-9
Hazardous Substances Data Bank. ETOPOSIDE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Experience with tamoxifen/etoposide in the treatment of a child with myxopapillary ependymoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ependymoma / diagnosis. Ependymoma / drug therapy. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Estrogen Receptor Modulators / administration & dosage. Etoposide / administration & dosage. Female. Humans. Laminectomy. Low Back Pain / etiology. Magnetic Resonance Imaging. Neoplasm Recurrence, Local. Radiotherapy, Adjuvant. Tamoxifen / administration & dosage. Treatment Outcome

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  • (PMID = 11466729.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen; 6PLQ3CP4P3 / Etoposide
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