Ependymoma
LMD disease, ependymoma
DISEASE, RECURRENCE, EPENDYMOMA
While all the patients with ependymoma had received EBRT at a median time of 1.2 years (range, 0.2–5.2) preceding cRIT, none had received EBRT as a bridge to cRIT after the most recent relapse (Table Five patients ultimately had progression at a median time of 0.4 years (range, 0.2–1.9) after most recent relapse and 0.2 years (range, 0.1–1.4) after cRIT initiation: two who were NED at cRIT initiation ultimately relapsed at or adjacent to the site of initial intraparenchymal disease, one had progression of the pre-cRIT measurable LMD disease in the spine but had PR in the intracranial LMD, one failed both at the measurable pre-cRIT site in the brain as well as developed new LMD in the spine, and one failed in both the brain parenchymal and had LMD in the spine (Supplemental Fig. 1). One patient who had measurable spine LMD at cRIT initiation was lost to follow up after initial post-cRIT MRI showed stable disease and he ultimately died 12.8 years after cRIT initiation (Fig. Three patients underwent additional focal EBRT to the brain following cRIT for progression (one patient received 5940 cGy) or recurrence (one patient received 4 additional courses to multiple sites in the brain with a maximum dose of 5400 cGy, another patient underwent stereotactic radiosurgery of unknown total dose). No patients received CSI post-cRIT. The one patient who is alive at last follow-up without evidence of disease was originally NED at cRIT initiation. Median OS was 7.1 years from pre-cRIT relapse (95% CI 0.5–12.9) and 6.7 years from cRIT initiation (95% CI 0.4–12.9; Fig. 