{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:04:35Z","timestamp":1762866275880},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,26]],"date-time":"2013-10-26T00:00:00Z","timestamp":1382745600000},"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":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Several trials incorporating adjuvant focal RT for treatment of young children with ependymoma have demonstrated improved survival with acceptable adverse effects. The optimal timing of RT administration is, however, unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>A retrospective review of territory\u2010wide database was performed to identify pediatric patients with ependymoma diagnosed between 1995 and 2011. OS and EFS were compared between patients receiving upfront RT (&lt;150 days of diagnosis), delayed RT (\u2265150 days of diagnosis), or no RT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010one patients with intracranial ependymoma were identified. Median age was 3.5 years and 14 (45%) were male. Primary tumor was supratentorial in 10 (32%) and infratentorial in 21 (68%). All patients underwent initial surgery, with gross\u2010total resection (GTR) in 27 (87%). Twelve (39%) received upfront RT, 10 (32%) had delayed RT and 9 (29%) had no RT. During the study period, there were 11 relapses (35%) and 10 deaths (32%). Five\u2010year OS was 69.9% and 5yr\u2010EFS was 49.3%. In univariate analysis, GTR led to improved OS (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and EFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.004); superior OS and EFS was observed in patients who received RT when compared with those without (<jats:italic>P<\/jats:italic>\u2009=\u20090.018 and 0.011, respectively). Upfront RT also resulted in better OS and EFS than delayed RT (<jats:italic>P<\/jats:italic>\u2009=\u20090.049 and 0.014, respectively). No significant effect on survival was observed with age, sex, tumor location, RT dosage, and protocol used. In multivariate analysis, GTR significantly improved OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) and EFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results support the early initiation of adjuvant RT in the multi\u2010modal management of pediatric ependymomas. Pediatr Blood Cancer 2014;61:606\u2013611. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24820","type":"journal-article","created":{"date-parts":[[2013,10,26]],"date-time":"2013-10-26T16:26:50Z","timestamp":1382804810000},"page":"606-611","source":"Crossref","is-referenced-by-count":14,"title":["Timing of adjuvant radiotherapy and treatment outcome in childhood ependymoma"],"prefix":"10.1002","volume":"61","author":[{"given":"Anthony Pak\u2010Yin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew Ming\u2010Kong","family":"Shing","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Leung","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chak\u2010Ho","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatics and Adolescent Medicine Tuen Mun Hospital Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siu\u2010Cheung","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Princess Margaret Hospital Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung\u2010Wing","family":"Luk","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shau\u2010Yin","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi\u2010Kong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora Lai\u2010Wan","family":"Kwong","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Queen Mary Hospital Li Ka Shing Faculty of Medicine, The University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Godfrey Chi\u2010Fung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong Hong Kong Special Administrative Region China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000028619"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.9.JNS08117"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70342-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:NEON.0000033383.84900.c1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199905000-00008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000028654"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199510000-00008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.88.4.0695"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.11.142"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(94)90061-2"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.03.052"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.11.058"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70208-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.10.043"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22782"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/1.3.177"},{"key":"e_1_2_7_18_1","unstructured":"SmithAA.COG\u2010ACNS 0831 phase III randomized trial of post\u2010radiation chemotherapy in patients with newly diagnosed ependymoma ages 1 to 21 years. 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