USE OF ADJUVANT ICE CHEMOTHERAPY IN THE TREATMENT OF ANAPLASTIC EPENDYMOMAS

Despite the improved outcome for patients with ependymoma treated by s urgery and radiotherapy, their prognosis remains relatively poor. To a ssess the impact of adjuvant chemotherapy, we reviewed the overall sur vival of consecutive patients with anaplastic ependymoma treated over a 10-year period with surgery and ICE (ifosfamide+ VP16+carboplatin) c hemotherapy with or without radiation at our institution. There were 1 1 patients (6 male, 5 female), with a median age of 3.4 years (range 1 .2-11.1): 4 under 2 years and 7 were over 2 years old. Overall, 5 had gross total resections: 4 are alive, 2 in continuous complete remissio n and 2 in second complete remission. One patient who was less than 2 years old died. Among the 6 with subtotal resection, 2 achieved a comp lete remission after chemotherapy. However, 5 of the 6 patients have s ince died of progressive disease, with a median overall survival of 75 months. Overall survival was 24% and progression-free survival was 39 %. In 2 of 6 patients with residual postoperative disease a temporary objective response was noted with adjuvant ICE chemotherapy. This regi men did not confer an overall survival advantage.