E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Adult Intracranial Ependymal Tumors: Results of TROD Neurooncology Group 07-009 Study
Suheyla Aytaç Arslan✉ ,
Petek Erpolat ,
Dicle Aslan ,
Yılmaz Tezcan ,
Emine Serra Kamer ,
Eda Erdiş ,
Gülhan Güler Avcı ,
Ela Delikgöz Soykut ,
Eda Küçüktülü ,
Banu Atalar ,
Fulya Ağaoğlu ,
Didem Karaçetin ,
İpek Pınar Aral ,
Ali Kerim Aksakal ,
Yıldız Güney
Ali Kerim Aksakal ,
Yıldız Güney
Radiation Oncology, Ankara City Hospital
DOI: 10.5137/1019-5149.JTN.49161-26.4
Accepted: 04/06/2026
Article in Press
Corresponding Author:
Suheyla Aytaç Arslan (saytac1@gmail.com)
Abstract
Aim
Intracranial ependymomas are rare in adults, with much of the literature focusing on pediatric cases. The standard treatment involves maximal safe resection often combined with radiotherapy (RT) and chemotherapy depending on the patient’s age, the tumor location, and the resection extent. Advances in RT have allowed for more precise re-irradiation in relapsed patients. This retrospective study aimed to evaluate the treatment outcomes for adults with intracranial ependymoma treated in radiation oncology clinics in our country.
Material and Methods
We reviewed the data of 53 adults diagnosed with ependymoma between February 13, 1998 and May 21, 2021 across nine centers in our country. The primary endpoints were overall survival (OS) and disease-free survival (DFS).
Results
The median follow-up duration was 48 months. By the final follow-up, 19 patients (35.8%) had relapsed. Of these, 16 received salvage treatments, including 12 who underwent re-irradiation. The median OS and DFS were 93 months and 78 months, respectively. Salvage treatment significantly influenced OS, with patients who received second-line RT demonstrating improved survival (89 vs. 21 months, p=0.007). DFS was notably affected by tumor location (supra vs. infra), type of surgery (GTR vs. others), and tumor grade (all <0.05).
Conclusion
The findings indicate that surgical type, tumor localization, and histological grade significantly impact DFS, while salvage RT positively affects OS, underscoring the need for tailored treatment strategies for relapsed patients.
Intracranial ependymomas are rare in adults, with much of the literature focusing on pediatric cases. The standard treatment involves maximal safe resection often combined with radiotherapy (RT) and chemotherapy depending on the patient’s age, the tumor location, and the resection extent. Advances in RT have allowed for more precise re-irradiation in relapsed patients. This retrospective study aimed to evaluate the treatment outcomes for adults with intracranial ependymoma treated in radiation oncology clinics in our country.
Material and Methods
We reviewed the data of 53 adults diagnosed with ependymoma between February 13, 1998 and May 21, 2021 across nine centers in our country. The primary endpoints were overall survival (OS) and disease-free survival (DFS).
Results
The median follow-up duration was 48 months. By the final follow-up, 19 patients (35.8%) had relapsed. Of these, 16 received salvage treatments, including 12 who underwent re-irradiation. The median OS and DFS were 93 months and 78 months, respectively. Salvage treatment significantly influenced OS, with patients who received second-line RT demonstrating improved survival (89 vs. 21 months, p=0.007). DFS was notably affected by tumor location (supra vs. infra), type of surgery (GTR vs. others), and tumor grade (all <0.05).
Conclusion
The findings indicate that surgical type, tumor localization, and histological grade significantly impact DFS, while salvage RT positively affects OS, underscoring the need for tailored treatment strategies for relapsed patients.
Keywords
intracranial ependymoma
radiotherapy
re-irridation
adult