SPINAL-CORD TUMORS IN CHILDREN - LONG-TERM RESULTS OF COMBINED SURGICAL AND RADIATION TREATMENT

The authors report a series of 31 children under 17 years of age with primary spinal cord tumors who underwent radiation treatment following decompression laminectomy with or without tumor resection between 195 9 and 1990. The tumors consisted of 15 astrocytomas, 11 ependymomas, o ne mixed glioma, one ganglioglioma, and three of unknown histology. Te n- and 20-year survival rates and 10- and 20-year relapse-free surviva l rates for the 28 patients with known histology were 80% and 53%, and 73% and 67%, respectively. Eleven patients (35%) had no resection, 14 (45%) had a partial resection, and six (19%) had a grossly complete r esection. Eight patients (26%) are dead: five due to recurrent tumor, two due to a second malignant tumor, and one due to intercurrent disea se. Primary tumor relapse or progression occurred in nine patients (29 %), four of whom were salvaged. A second malignant tumor developed in four patients (13%), two of whom died. Local control of the tumor was finally achieved in 26 cases (84%), despite either grossly incomplete or no resection in 25 of these cases (81%). These statistics suggest t hat radiation treatment without resection may achieve long-term contro l in children with astrocytoma or ependymoma of the spinal cord.