{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:54:33Z","timestamp":1780667673679,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,3,15]],"date-time":"2005-03-15T00:00:00Z","timestamp":1110844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2005,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ependymal tumors are classified as ependymoma (benign or low grade) versus anaplastic ependymoma (malignant or high grade). Ependymomas represent 5\u201310% of intracranial neoplasm in children. In this study, demographic data and the treatment results of pediatric patients with ependymal tumors, treated in a single institute, is reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Between 1989 and 2001, 40 (22 M\/18 F) previously untreated patients with a median age of 5.5 years (3 months\u201315 years), of histologically proven ependymal tumors (except ependymoblastomas) were referred to the Institute of Oncology, University of Istanbul. The localization was supratentorial in 18, infratentorial in 20, both supra and infratentorial in two patients. Histologic subgroups were 18 ependymomas (43.6%), and 22 anaplastic ependymomas (56.4%). Total tumor resection was performed in 20 patients (50%), subtotal in 18 patients (45%), and biopsy only in 2 patients (5%). Postoperative treatment consisted of regional (8 patients) or craniospinal (CSI) (9 patients) radiotherapy (RT) in patients with ependymoma; regional (7 patients) or CSI RT (14 patients) with chemotherapy (ChT) in patients with anaplastic ependymoma; ChT only (1 patient) in patients less than 3 years of age. The standard technique for posterior fossa irradiation was parallel\u2010opposed lateral fields and total dose was 45\u201354 Gy. Between September 1989 and May 1991 patients received regimen A, which consisted of RT followed by eight\u2010in\u2010one ChT, given every 4 weeks for eight courses. Patients who were treated between June 1991 and July 1994, received regimen B, which included two courses of postoperative \u201cVEC\u201d (vincristine, etoposide, cisplatin) ChT, administered every 3 weeks, followed by RT applied with low dose concomitant cisplatin used as a radiosensitizer. Patients with objective response to postoperative \u201cVEC\u201d continued to have \u201cVEC\u201d after completion of RT for six more courses. From August 1994 on, patients received regimen C, consisting of RT and concomitant infusion of cisplatin followed by \u201cVCPCU\u201d (vincristine, cyclophosphamide, procarbazine, lomustine) administered every 4 weeks for eight courses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 40 patients were included in the outcome and survival data. The 5\u2010year overall survival (OS) rate was 64.9%, and the 5\u2010year progression\u2010free survival rate was 50.8% for the whole series. Median time for progression or relapse was 24.3 months and there were 19 patients (43.6%) with relapse or progression. Non\u2010metastatic patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.0008, 5\u2010year OS rate was 82% vs. 29%), and totally resected patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.01, 5\u2010year OS rate was 80% vs. 55%), and \u22653 years of age (<jats:italic>P<\/jats:italic>\u2009=\u20090.04, 5\u2010year OS rate was 75% vs. 38%) had significantly better outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The majority of complete responders were patients who had total tumor removal. Treatment failure occurred mainly within the first 2 years, and outcome was dismal for patients who relapsed or had progressive disease. The median age at diagnosis is 6 years in our patient group; younger children (less than 3 years old) have less favorable outcome. There was no significant difference in survival or progression\u2010free survival between the two histologic subtypes. \u00a9 2005 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.20212","type":"journal-article","created":{"date-parts":[[2005,3,16]],"date-time":"2005-03-16T04:46:23Z","timestamp":1110948383000},"page":"298-303","source":"Crossref","is-referenced-by-count":40,"title":["Ependymal tumors in childhood"],"prefix":"10.1002","volume":"45","author":[{"given":"Fulya Yaman","family":"Agaoglu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inci","family":"Ayan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavuz","family":"Dizdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rejin","family":"Kebudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Gorgun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emin","family":"Darendeliler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,3,15]]},"reference":[{"key":"e_1_2_5_2_2","volume-title":"Pediatric radiation oncology","author":"Halperin EC","year":"1999"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000120509"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-8140(95)01605-G"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(92)90747-6"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1990.72.3.0408"},{"key":"e_1_2_5_7_2","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1227\/00006123-199105000-00005","article-title":"The prognostic significance of postoperative residual tumor in ependymoma","volume":"28","author":"Healey E","year":"1991","journal-title":"Neurosurgery"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199708)29:2<79::AID-MPO3>3.0.CO;2-O"},{"key":"e_1_2_5_9_2","first-page":"313","article-title":"Treatment of intracranial ependymomas of children: Review of a 15 year experience","volume":"23","author":"Rousseau P","year":"1993","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2003.08.030"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197506)35:6<1563::AID-CNCR2820350614>3.0.CO;2-I"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1983.59.4.0652"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.85.4.0618"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19910601)67:11<2766::AID-CNCR2820671109>3.0.CO;2-#"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(00)01353-5"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199806)30:6<319::AID-MPO1>3.0.CO;2-H"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(83)90169-4"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(97)00138-2"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(91)90704-8"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.86.6.0943"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0344-0338(96)80100-2"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1989.70.1.0031"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00414-9"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199607)27:1<8::AID-MPO3>3.0.CO;2-K"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970715)80:2<341::AID-CNCR23>3.0.CO;2-T"},{"key":"e_1_2_5_26_2","first-page":"269","article-title":"Intracranial ependymomas: Treatment results and prognostic factors","volume":"12","author":"Zorlu AF","year":"1994","journal-title":"Radiat Med"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1159\/000121027"}],"container-title":["Pediatric Blood &amp; 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