Outcome and prognostic factors of radiation therapy for XXXX .

@entity1 @entity137 @entity5 @entity2269 @entity2946 @entity1349
PURPOSE: To investigate treatment outcome and prognostic factors after radiation therapy in @entity1 with @entity2946 ( @entity2946 ). METHODS AND MATERIALS: Sixty-six @entity1 with histologically confirmed @entity2946 were treated at the University Hospital of Heidelberg between 1985 and 2009. Forty-two @entity1 (64%) were pediatric ( <= 18 years), and 24 @entity1 (36%) were adults. @entity5 resection was performed in all @entity1 and was complete in 47%. All @entity1 underwent postoperative craniospinal irradiation (CSI) delivering a median craniospinal dose of 35.5 Gy with additional boosts to the posterior fossa up to 54.0 Gy. Forty-seven @entity1 received chemotherapy, including 21 in whom chemotherapy was administered before CSI. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. RESULTS: Median follow-up was 93 months. @entity1349 ( @entity1349 ) and local and distant progression-free survival (LPFS and DPFS) were 73%, 62%, and 77% at 60 months. Both local and distant recurrence predisposed for significantly reduced @entity1349 . Macroscopic complete tumor resection, desmoplastic histology and early initiation of postoperative radiation therapy within 28 days were associated with improved outcome. The addition of chemotherapy did not improve survival rates. @entity137 was moderate. CONCLUSIONS: Complete resection of @entity2946 followed by CSI yields long survival rates in both @entity1 and adults. Delayed initiation of CSI is associated with poor outcome. @entity2269 histology is associated with improved survival. The role of chemotherapy, especially in the adult population, must be further investigated in clinical studies.
