Irradiation of pediatric high-grade spinal cord tumors

Rahul D. Tendulkar, Atmaram S. Pai Panandiker, Shengjie Wu, Larry E. Kun, Alberto Broniscer, Robert A. Sanford, Thomas E. Merchant

Research output: Contribution to journalArticle

25 Scopus citations


Purpose: To report the outcome using radiation therapy (RT) for pediatric patients with high-grade spinal cord tumors. Methods and Materials: A retrospective chart review was conducted that included 17 children with high-grade spinal cord tumors treated with RT at St. Jude Children's Research Hospital between 1981 and 2007. Three patients had gross total resection, 11 had subtotal resection, and 3 underwent biopsy. The tumor diagnosis was glioblastoma multiforme (n = 7), anaplastic astrocytoma (n = 8), or anaplastic oligodendroglioma (n = 2). Seven patients received craniospinal irradiation (34.2-48.6 Gy). The median dose to the primary site was 52.2 Gy (range, 38-66 Gy). Results: The median progression-free and overall survivals were 10.8 and 13.8 months, respectively. Local tumor progression at 12 months (79% vs. 30%, p = 0.02) and median survival (13.1 vs. 27.2 months, p = 0.09) were worse for patients with glioblastoma multiforme compared with anaplastic astrocytoma or oligodendroglioma. The median overall survival was shorter for patients when failure included neuraxis dissemination (n = 8) compared with local failure alone (n = 5), 9.6 vs. 13.8 months, p = 0.08. Three long-term survivors with World Health Organization Grade III tumors were alive with follow-up, ranging from 88-239 months. Conclusions: High-grade spinal cord primary tumors in children have a poor prognosis. The propensity for neuraxis metastases as a component of progression after RT suggests the need for more aggressive therapy.

Original languageEnglish (US)
Pages (from-to)1451-1456
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number5
StatePublished - Dec 1 2010


  • CNS neoplasms
  • Pediatrics
  • Radiotherapy
  • Spinal cord tumors

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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  • Cite this

    Tendulkar, R. D., Pai Panandiker, A. S., Wu, S., Kun, L. E., Broniscer, A., Sanford, R. A., & Merchant, T. E. (2010). Irradiation of pediatric high-grade spinal cord tumors. International Journal of Radiation Oncology Biology Physics, 78(5), 1451-1456.