Five years{u2019} experience of pediatric treatment in ependymal CNS tumors at the National cancer institute, Egypt / Maryhan Hosny Ghazy ; Supervised Mohamed Fawzy Ibrahim , Ehab Mohamed Khalil , Mahmoud Hammad Mahmoud

Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background: Ependymomas are the third most common paediatric central nervous system (CNS) tumours, accounting for 6-12% of brain tumours in children. Despite advances in neurosurgery, neuroimaging and postoperative adjuvant therapy, management of these tumours remains challenging, and recurrence occurs in over 50% of cases, particularly when complete resection is not achieved prior to conformal radiotherapy. The 5-year overall survival (OS) ranges from 39% to 64%, with a 5-year progression-free survival (PFS) rate of 23% to 45%. Purpose: Primary study outcomes included the overall survival (OS) and progression free survival (PFS) of ependymoma tumor. Secondary outcomes included effect of different treatment regimen given, and the relation between different study variables including age, gender, histopathological subtype, tumor size, site of the primary, extent of disease, and their reflection on the outcome. Methods: This is a retrosepective study, which included fourty seven (47) pediatric patients diagnosed with ependymoma. These patients presented to National cancer Insitute, Cairo university during the period from January 2009 to December 2014. Results: The median follow up time was 23.5 months, ranging from 2 to 77 months. The estimate 2 years overall survival and progression free survival was 57.4% and 50.9 % respectively. Regarding the factors which affect outcome was: Surgical excision (p value =0.048), post operative radiotherapy (p value =<0.001). Conclusion: Extent of surgical resection especially growth total resection (GTR) and postoperative radiotherapy are the main factors which improve outcome. New therapeutic modalities yet to be explored to improve outcome

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