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Objective: To investigate the clinical features and prognosis of intracranial embryonal tumors in children. Methods: Clinical data of 27 patients with intracranial embryonal tumors who were admitted to Beijing Shijitan Hospital, Capital Medical University be-tween May 2011 and December 2018 were retrospectively analyzed. Results: The study included 27 patients, comprising 17 male and 10 female children, with a median age of 7 years. Twelve patients underwent gross total resection, and 15 patients underwent subto-tal resection. After surgery, all 27 patients underwent craniospinal irradiation. The dose of craniospinal irradiation was 27-30.6 Gy, and the dose of the tumor bed was 55.8-60 Gy. Twenty-two patients underwent chemotherapy regimen composed of irinotecan, vtncris-tine, etoposide, nedaplatin after radiotherapy. The median follow-up period was 22 (4-93) months. Nine patients are alive without lo-cal or distant recurrence. Eighteen patients died; the causes of death were intracranial recurrence and spinal cord metastasis. The 1-, 3-, and 5-year survival rates were 79.4%, 50.2%, and 36.5%, respectively. Conclusions: Intracranial embryonal tumors in children are rare and malignant and can metastasize along the neuroaxis. Surgery, adjuvant radiotherapy, and chemotherapy are important for pa-tients with intracranial embryonal tumors. Moreover, the prognosis is poor.
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objective:To investigate the clinical features and prognosis of pinealoblastoma in children. Methods:The clinical data of 10 patients with pinealoblastoma were retrospectively analyzed. These patients were admitted to the Department of Radiation Oncology, Beijing Shijitan Hospital, Capital Medical University from December 2011 to December 2015. Results:This study included 10 patients, with 8 males and 2 females, with a median age of 7 years. Of the 10 patients, 5 underwent gross total resection and 5 underwent sub-total resection. The 10 patients were exposed to craniospinal irradiation after surgery. The median doses of craniospinal irradiation and tumor bed were 30.6 (25.5-36) Gy and 55.8 (50.4-60) Gy, respectively. Of the 10 patients, 4 underwent chemotherapy 1 month af-ter radiotherapy. The median follow-up period was 16.5 (1.5-49) months. The 10 patients survived. No local and distant recurrences were observed. Conclusion:Pinealoblastomas are rare, malignant, and pineal regional lesions that can metastasize along the neuroax-is. Surgery combined with adjuvant radiotherapy and chemotherapy should be applied to patients with pinealoblastoma. Prognosis is also favorable.
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Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.
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Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.
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Objective To evaluate the difference between CT and CT/MR DWI images for gross tumor volume (GTV) delineation in precision radiotherapy for esophageal squamous cell carcinoma.Methods 20 patients with pathologically confirmed as esophageal squamous cell carcinoma were selected for target delineation.The GTV based on CT and CT/MR DWI images of the patients were delineated by six radiation oncologists.The mean,standard deviation,coefficient of variation (CV =standard deviation/mean) of GTV volume,the ratio of minimum value and maximum value (ratio =maximum value/minimum value) of the GTV volume were calculated.And the CV and ratio of the GTV by the two methods were compared.Results The biggest difference of GTV volume on CT and on CT/MR DWI images was 55.71 and 13.89 cm3 (F =12.80,P ＜ 0.05).The CV on CT and CT/MR DWI images were 0.30 ± 0.08,0.11-±0.04 (Z =-3.92,P ＜ 0.05),and the ratio of GTV volume were 2.38 ± 0.62,1.34 ± 0.13,respectively (Z =-3.92,P ＜ 0.05).Conclusions CT/MR DWI images could display GTV more directly,which may help to increase consistency of GTV for esophageal squamous cell carcinoma delineation among different radiation oncologists.