Pediatric low-grade and ependymal spinal cord tumors

Our institutional experience with pediatric spinal cord tumors includes 25 patients with the diagnosis of ependymoma (EP; n = 4), myxopapillary ependy moma (MPEP; n = 4), juvenile pilocytic astrocytoma (JPA; n = 5), nonpilocyt ic astrocytoma (WHO grade I or II, n = 6), and other nonastrocytic spinal c ord tumors (n = 6) treated during the period 1974-1999. Nineteen patients r equired radiation therapy (RT). The median progression-free survival follow ing RT was 65 months (range 1-206 months). Seven patients recurred at an av erage of 22 months. The EP patients recurred at an average of 8.5 months, w hile the patients with low-grade astrocytoma recurred at an average of 42 m onths. including the 6 nonsurviving patients, the median overall survival w as 96 months. Two EP patients died with a progression-free survival of 9 mo nths. One patient with MPEP died of other causes at 7 months. The treatment of pediatric spinal cord tumors should be individualized based on the hist ologic type. Radical surgery is indicated for nonmyxopapillary EP and low-g rade astrocytic tumors. The need for adjuvant therapy most often depends on the extent of resection as well as the tumor type. Patients with dissemina ted EP, MPEP, JPA and nonpilocytic astrocytoma may achieve long-term progre ssion-free survival with craniospinal irradiation. Copyright (C) 2000 S. Ka rger AG. Basel.