Adjuvant Therapies for Intramedullary Spinal Cord Tumors in Children

Radiation Therapy

• 75–80% 5-year event-free survival with conservative surgery followed by radiation: This rate is the cited experience in papers published between 1992 and 2000 (2, 32, 42, 46).
• 71% (17/22) 10-year event-free survival with surgery followed by radiation: This rate was reported in one study of children treated with surgery followed by radiation, and 75% (18/22) were alive at 10 years. Four had experienced second malignancies, and another two had late occurrence of anaplastic astrocytomas (37).
• Anaplastic IMSCTs and recurrent low-grade IMSCTs: For these tumors in older children and adolescents, there is consensus for the use of radiation therapy (34).

Chemotherapy

• Little information available: Reports on the use of chemotherapy for benign IMSCTs are largely case reports or very small series.
• Reports difficult to interpret: The studies that are available are difficult to interpret, given the indolent nature of these tumors, the short follow-up of the studies, and the small number of children in studies.