TY - JOUR T1 - Wide-field Pulsed Reduced Dose Rate Radiotherapy (PRDR) for Recurrent Ependymoma in Pediatric and Young Adult Patients JF - Anticancer Research JO - Anticancer Res SP - 2611 LP - 2618 VL - 33 IS - 6 AU - PRANSHU MOHINDRA AU - H. IAN ROBINS AU - WOLFGANG A. TOMÉ AU - LORI HAYES AU - STEVEN P. HOWARD Y1 - 2013/06/01 UR - http://ar.iiarjournals.org/content/33/6/2611.abstract N2 - Aim: This retrospective analysis evaluates feasibility of wide-field re-irradiation using pulsed reduced dose rate (PRDR) technique in patients with recurrent ependymoma. PRDR employs a dose rate of 6 cGy/min, as opposed to 400-600 cGy/min for conventional radiation, allowing for enhanced normal tissue repair. Patients and Methods: Five patients with recurrent ependymoma having eight lesions (two brain, six spinal cord) were treated with PRDR. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan Meier method. Results: The median interval between two radiation courses was 58 months (range: 32-212 months). The median PRDR dose was 40 Gy (range: 30.6-54 Gy) with a median cumulative lifetime dose of 105.2 Gy (range: 90-162.4 Gy). At a median post-PRDR follow-up of 64 months, estimated 4-year OS and PFS from PRDR was 60% and 35.7%, respectively. None of the patients developed necrosis on serial magnetic resonance imaging scans, and only one patient had progressive mild radiculopathy. Conclusion: In patients with large-volume recurrent ependymoma, re-irradiation with wide-field PRDR is a feasible option. ER -