Therapeutic Impact of Cytoreductive Surgery and Irradiation of
Posterior Fossa Ependymoma in the Molecular Era: A
Retrospective Multicohort Analysis

J 2016

Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis

RAMASWAMY, Vijay, Thomas HIELSCHER, Stephen C. MACK, Alvaro LASSALETTA, Tong LIN et. al.

Základní údaje

Originální název

Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis

Autoři

RAMASWAMY, Vijay (124 Kanada), Thomas HIELSCHER (276 Německo), Stephen C. MACK (124 Kanada), Alvaro LASSALETTA (124 Kanada), Tong LIN (840 Spojené státy), Kristian W. PAJTLER (276 Německo), David T.W. JONES (276 Německo), Betty LUU (124 Kanada), Florence M.G. CAVALLI (124 Kanada), Kenneth ALDAPE (124 Kanada), Marc REMKE (276 Německo), Martin MYNAREK (276 Německo), Stefan RUTKOWSKI (276 Německo), Sridharan GURURANGAN (840 Spojené státy), Roger E. MCLENDON (840 Spojené státy), Eric S. LIPP (840 Spojené státy), Christopher DUNHAM (124 Kanada), Juliette HUKIN (124 Kanada), David D. EISENSTAT (124 Kanada), Dorcas FULTON (124 Kanada), Frank K. H. van LANDEGHEM (124 Kanada), Mariarita SANTI (840 Spojené státy), Marie-Lise C. van VEELEN (528 Nizozemské království), Erwin G. VAN MEIR (840 Spojené státy), Satoru OSUKA (840 Spojené státy), Xing FAN (840 Spojené státy), Karin M. MURASZKO (840 Spojené státy), Daniela P.C. TIRAPELLI (76 Brazílie), Sueli M. OBA-SHINJO (76 Brazílie), Suely K.N. MARIE (76 Brazílie), Carlos G. CARLOTTI (76 Brazílie), Ji Yeoun LEE (410 Korejská republika), Amulya A. Nagesware RAO (840 Spojené státy), Caterina GIANNINI (840 Spojené státy), Claudia C. FARIA (620 Portugalsko), Sofia NUNES (620 Portugalsko), Jaume MORA (724 Španělsko), Ronald L. HAMILTON (840 Spojené státy), Peter HAUSER (348 Maďarsko), Nada JABADO (124 Kanada), Kevin PETRECCA (124 Kanada), Shin JUNG (410 Korejská republika), Luca MASSIMI (380 Itálie), Massimo ZOLLO (380 Itálie), Giuseppe CINALLI (380 Itálie), László BOGNÁR (348 Maďarsko), Almos KLEKNER (348 Maďarsko), Tibor HORTOBÁGYI (348 Maďarsko), Sarah LEARY (840 Spojené státy), Ralph P. ERMOIAN (840 Spojené státy), James M. OLSON (840 Spojené státy), Jeffrey R. LEONARD (840 Spojené státy), Corrine GARDNER (840 Spojené státy), Wieslawa A. GRAJKOWSKA (616 Polsko), Lola B. CHAMBLESS (840 Spojené státy), Jason CAIN (36 Austrálie), Charles G. EBERHART (840 Spojené státy), Sama AHSAN (840 Spojené státy), Maura MASSIMINO (380 Itálie), Felice GIANGASPERO (380 Itálie), Francesca R. BUTTARELLI (380 Itálie), Roger J. PACKER (840 Spojené státy), Lyndsey EMERY (840 Spojené státy), William H. YONG (840 Spojené státy), Horacio SOTO (840 Spojené státy), Linda M. LIAU (840 Spojené státy), Richard EVERSON (840 Spojené státy), Andrew GROSSBACH (840 Spojené státy), Tarek SHALABY (756 Švýcarsko), Michael GROTZER (756 Švýcarsko), Matthias A. KARAJANNIS (840 Spojené státy), David ZAGZAG (840 Spojené státy), Helen WHEELER (36 Austrálie), Katja von HOFF (276 Německo), Marta M. ALONSO (724 Španělsko), Teresa TUON (724 Španělsko), Ulrich SCHÜLLER (276 Německo), Karel ZITTERBART (203 Česká republika, garant, domácí), Jaroslav ŠTĚRBA (203 Česká republika, domácí), Jennifer A. CHAN (124 Kanada), Miguel GUZMAN (840 Spojené státy), Samer K. ELBABAA (840 Spojené státy), Howard COLMAN (840 Spojené státy), Girish DHALL (840 Spojené státy), Paul G. FISHER (840 Spojené státy), Maryam FOULADI (840 Spojené státy), Amar GAJJAR (840 Spojené státy), Stewart GOLDMAN (840 Spojené státy), Eugene HWANG (840 Spojené státy), Marcel KOOL (276 Německo), Harshad LADHA (840 Spojené státy), Elizabeth VERA-BOLANOS (840 Spojené státy), Khalida WANI (840 Spojené státy), Frank LIEBERMAN (840 Spojené státy), Tom MIKKELSEN (840 Spojené státy), Antonio M. OMURO (840 Spojené státy), Ian F. POLLACK (840 Spojené státy), Michael PRADOS (840 Spojené státy), H. Ian ROBINS (840 Spojené státy), Riccardo SOFFIETTI (380 Itálie), Jing WU (840 Spojené státy), Phillipe METELLUS (250 Francie), Uri TABORI (124 Kanada), Ute BARTELS (124 Kanada), Eric BOUFFET (124 Kanada), Cynthia E. HAWKINS (124 Kanada), James T. RUTKA (124 Kanada), Peter DIRKS (124 Kanada), Stefan M. PFISTER (276 Německo), Thomas E. MERCHANT (840 Spojené státy), Mark R. GILBERT (840 Spojené státy), Terri S. ARMSTRONG (840 Spojené státy), Andrey KORSHUNOV (276 Německo), David W. ELLISON (840 Spojené státy) a Michael D. TAYLOR (124 Kanada)

Vydání

Journal of Clinical Oncology, Alexandria, American Society of Clinical Oncology, 2016, 0732-183X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 24.008

Kód RIV

RIV/00216224:14110/16:00092056

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1200/JCO.2015.65.7825

UT WoS

000381497000006

Klíčová slova anglicky

CONFORMAL RADIATION-THERAPY; NEWLY-DIAGNOSED EPENDYMOMA; PHASE-II TRIAL; BRAIN-TUMORS; PEDIATRIC-PATIENTS; CRANIAL RADIATION; CHILDREN; CHILDHOOD; CHEMOTHERAPY; AGE

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 1. 12. 2016 11:49, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Purpose Posterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known.MethodsFour independent nonoverlapping retrospective cohorts of posterior fossa ependymomas (n = 820) were profiled using genome-wide methylation arrays. Risk stratification models were designed based on known clinical and newly described molecular biomarkers identified by multivariable Cox proportional hazards analyses. Results Molecular subgroup is a powerful independent predictor of outcome even when accounting for age or treatment regimen. Incompletely resected EPN_PFA ependymomas have a dismal prognosis, with a 5-year progression-free survival ranging from 26.1% to 56.8% across all four cohorts. Although first-line (adjuvant) radiation is clearly beneficial for completely resected EPN_PFA, a substantial proportion of patients with EPN_PFB can be cured with surgery alone, and patients with relapsed EPN_PFB can often be treated successfully with delayed external-beam irradiation. Conclusion The most impactful biomarker for posterior fossa ependymoma is molecular subgroup affiliation, independent of other demographic or treatment variables. However, both EPN_PFA and EPN_PFB still benefit from increased extent of resection, with the survival rates being particularly poor for subtotally resected EPN_PFA, even with adjuvant radiation therapy. Patients with EPN_PFB who undergo gross total resection are at lower risk for relapse and should be considered for inclusion in a randomized clinical trial of observation alone with radiation reserved for those who experience recurrence.

Návaznosti

ROZV/20/LF/2015, interní kód MU

Název: LF - Příspěvek IP 2015

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, LF - Příspěvek IP 2015

Citovat

RAMASWAMY, Vijay, Thomas HIELSCHER, Stephen C. MACK, Alvaro LASSALETTA, Tong LIN, Kristian W. PAJTLER, David T.W. JONES, Betty LUU, Florence M.G. CAVALLI, Kenneth ALDAPE, Marc REMKE, Martin MYNAREK, Stefan RUTKOWSKI, Sridharan GURURANGAN, Roger E. MCLENDON, Eric S. LIPP, Christopher DUNHAM, Juliette HUKIN, David D. EISENSTAT, Dorcas FULTON, Frank K. H. van LANDEGHEM, Mariarita SANTI, Marie-Lise C. van VEELEN, Erwin G. VAN MEIR, Satoru OSUKA, Xing FAN, Karin M. MURASZKO, Daniela P.C. TIRAPELLI, Sueli M. OBA-SHINJO, Suely K.N. MARIE, Carlos G. CARLOTTI, Ji Yeoun LEE, Amulya A. Nagesware RAO, Caterina GIANNINI, Claudia C. FARIA, Sofia NUNES, Jaume MORA, Ronald L. HAMILTON, Peter HAUSER, Nada JABADO, Kevin PETRECCA, Shin JUNG, Luca MASSIMI, Massimo ZOLLO, Giuseppe CINALLI, László BOGNÁR, Almos KLEKNER, Tibor HORTOBÁGYI, Sarah LEARY, Ralph P. ERMOIAN, James M. OLSON, Jeffrey R. LEONARD, Corrine GARDNER, Wieslawa A. GRAJKOWSKA, Lola B. CHAMBLESS, Jason CAIN, Charles G. EBERHART, Sama AHSAN, Maura MASSIMINO, Felice GIANGASPERO, Francesca R. BUTTARELLI, Roger J. PACKER, Lyndsey EMERY, William H. YONG, Horacio SOTO, Linda M. LIAU, Richard EVERSON, Andrew GROSSBACH, Tarek SHALABY, Michael GROTZER, Matthias A. KARAJANNIS, David ZAGZAG, Helen WHEELER, Katja von HOFF, Marta M. ALONSO, Teresa TUON, Ulrich SCHÜLLER, Karel ZITTERBART, Jaroslav ŠTĚRBA, Jennifer A. CHAN, Miguel GUZMAN, Samer K. ELBABAA, Howard COLMAN, Girish DHALL, Paul G. FISHER, Maryam FOULADI, Amar GAJJAR, Stewart GOLDMAN, Eugene HWANG, Marcel KOOL, Harshad LADHA, Elizabeth VERA-BOLANOS, Khalida WANI, Frank LIEBERMAN, Tom MIKKELSEN, Antonio M. OMURO, Ian F. POLLACK, Michael PRADOS, H. Ian ROBINS, Riccardo SOFFIETTI, Jing WU, Phillipe METELLUS, Uri TABORI, Ute BARTELS, Eric BOUFFET, Cynthia E. HAWKINS, James T. RUTKA, Peter DIRKS, Stefan M. PFISTER, Thomas E. MERCHANT, Mark R. GILBERT, Terri S. ARMSTRONG, Andrey KORSHUNOV, David W. ELLISON a Michael D. TAYLOR. Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis. Journal of Clinical Oncology. Alexandria: American Society of Clinical Oncology, 2016, roč. 34, č. 21, s. 2468-2490. ISSN 0732-183X. Dostupné z: https://dx.doi.org/10.1200/JCO.2015.65.7825.

@article{1362990,
   author = {Ramaswamy, Vijay and Hielscher, Thomas and Mack, Stephen C. and Lassaletta, Alvaro and Lin, Tong and Pajtler, Kristian W. and Jones, David T.W. and Luu, Betty and Cavalli, Florence M.G. and Aldape, Kenneth and Remke, Marc and Mynarek, Martin and Rutkowski, Stefan and Gururangan, Sridharan and McLendon, Roger E. and Lipp, Eric S. and Dunham, Christopher and Hukin, Juliette and Eisenstat, David D. and Fulton, Dorcas and Landeghem, Frank K. H. van and Santi, Mariarita and Veelen, MarieandLise C. van and Van Meir, Erwin G. and Osuka, Satoru and Fan, Xing and Muraszko, Karin M. and Tirapelli, Daniela P.C. and ObaandShinjo, Sueli M. and Marie, Suely K.N. and Carlotti, Carlos G. and Lee, Ji Yeoun and Rao, Amulya A. Nagesware and Giannini, Caterina and Faria, Claudia C. and Nunes, Sofia and Mora, Jaume and Hamilton, Ronald L. and Hauser, Peter and Jabado, Nada and Petrecca, Kevin and Jung, Shin and Massimi, Luca and Zollo, Massimo and Cinalli, Giuseppe and Bognár, László and Klekner, Almos and Hortobágyi, Tibor and Leary, Sarah and Ermoian, Ralph P. and Olson, James M. and Leonard, Jeffrey R. and Gardner, Corrine and Grajkowska, Wieslawa A. and Chambless, Lola B. and Cain, Jason and Eberhart, Charles G. and Ahsan, Sama and Massimino, Maura and Giangaspero, Felice and Buttarelli, Francesca R. and Packer, Roger J. and Emery, Lyndsey and Yong, William H. and Soto, Horacio and Liau, Linda M. and Everson, Richard and Grossbach, Andrew and Shalaby, Tarek and Grotzer, Michael and Karajannis, Matthias A. and Zagzag, David and Wheeler, Helen and Hoff, Katja von and Alonso, Marta M. and Tuon, Teresa and Schüller, Ulrich and Zitterbart, Karel and Štěrba, Jaroslav and Chan, Jennifer A. and Guzman, Miguel and Elbabaa, Samer K. and Colman, Howard and Dhall, Girish and Fisher, Paul G. and Fouladi, Maryam and Gajjar, Amar and Goldman, Stewart and Hwang, Eugene and Kool, Marcel and Ladha, Harshad and VeraandBolanos, Elizabeth and Wani, Khalida and Lieberman, Frank and Mikkelsen, Tom and Omuro, Antonio M. and Pollack, Ian F. and Prados, Michael and Robins, H. Ian and Soffietti, Riccardo and Wu, Jing and Metellus, Phillipe and Tabori, Uri and Bartels, Ute and Bouffet, Eric and Hawkins, Cynthia E. and Rutka, James T. and Dirks, Peter and Pfister, Stefan M. and Merchant, Thomas E. and Gilbert, Mark R. and Armstrong, Terri S. and Korshunov, Andrey and Ellison, David W. and Taylor, Michael D.},
   article_location = {Alexandria},
   article_number = {21},
   doi = {http://dx.doi.org/10.1200/JCO.2015.65.7825},
   keywords = {CONFORMAL RADIATION-THERAPY; NEWLY-DIAGNOSED EPENDYMOMA; PHASE-II TRIAL; BRAIN-TUMORS; PEDIATRIC-PATIENTS; CRANIAL RADIATION; CHILDREN; CHILDHOOD; CHEMOTHERAPY; AGE},
   language = {eng},
   issn = {0732-183X},
   journal = {Journal of Clinical Oncology},
   title = {Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis},
   volume = {34},
   year = {2016}
}

TY  - JOUR
ID  - 1362990
AU  - Ramaswamy, Vijay - Hielscher, Thomas - Mack, Stephen C. - Lassaletta, Alvaro - Lin, Tong - Pajtler, Kristian W. - Jones, David T.W. - Luu, Betty - Cavalli, Florence M.G. - Aldape, Kenneth - Remke, Marc - Mynarek, Martin - Rutkowski, Stefan - Gururangan, Sridharan - McLendon, Roger E. - Lipp, Eric S. - Dunham, Christopher - Hukin, Juliette - Eisenstat, David D. - Fulton, Dorcas - Landeghem, Frank K. H. van - Santi, Mariarita - Veelen, Marie-Lise C. van - Van Meir, Erwin G. - Osuka, Satoru - Fan, Xing - Muraszko, Karin M. - Tirapelli, Daniela P.C. - Oba-Shinjo, Sueli M. - Marie, Suely K.N. - Carlotti, Carlos G. - Lee, Ji Yeoun - Rao, Amulya A. Nagesware - Giannini, Caterina - Faria, Claudia C. - Nunes, Sofia - Mora, Jaume - Hamilton, Ronald L. - Hauser, Peter - Jabado, Nada - Petrecca, Kevin - Jung, Shin - Massimi, Luca - Zollo, Massimo - Cinalli, Giuseppe - Bognár, László - Klekner, Almos - Hortobágyi, Tibor - Leary, Sarah - Ermoian, Ralph P. - Olson, James M. - Leonard, Jeffrey R. - Gardner, Corrine - Grajkowska, Wieslawa A. - Chambless, Lola B. - Cain, Jason - Eberhart, Charles G. - Ahsan, Sama - Massimino, Maura - Giangaspero, Felice - Buttarelli, Francesca R. - Packer, Roger J. - Emery, Lyndsey - Yong, William H. - Soto, Horacio - Liau, Linda M. - Everson, Richard - Grossbach, Andrew - Shalaby, Tarek - Grotzer, Michael - Karajannis, Matthias A. - Zagzag, David - Wheeler, Helen - Hoff, Katja von - Alonso, Marta M. - Tuon, Teresa - Schüller, Ulrich - Zitterbart, Karel - Štěrba, Jaroslav - Chan, Jennifer A. - Guzman, Miguel - Elbabaa, Samer K. - Colman, Howard - Dhall, Girish - Fisher, Paul G. - Fouladi, Maryam - Gajjar, Amar - Goldman, Stewart - Hwang, Eugene - Kool, Marcel - Ladha, Harshad - Vera-Bolanos, Elizabeth - Wani, Khalida - Lieberman, Frank - Mikkelsen, Tom - Omuro, Antonio M. - Pollack, Ian F. - Prados, Michael - Robins, H. Ian - Soffietti, Riccardo - Wu, Jing - Metellus, Phillipe - Tabori, Uri - Bartels, Ute - Bouffet, Eric - Hawkins, Cynthia E. - Rutka, James T. - Dirks, Peter - Pfister, Stefan M. - Merchant, Thomas E. - Gilbert, Mark R. - Armstrong, Terri S. - Korshunov, Andrey - Ellison, David W. - Taylor, Michael D.
PY  - 2016
TI  - Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis
JF  - Journal of Clinical Oncology
VL  - 34
IS  - 21
SP  - 2468-2490
EP  - 2468-2490
PB  - American Society of Clinical Oncology
SN  - 0732183X
KW  - CONFORMAL RADIATION-THERAPY
KW  - NEWLY-DIAGNOSED EPENDYMOMA
KW  - PHASE-II TRIAL
KW  - BRAIN-TUMORS
KW  - PEDIATRIC-PATIENTS
KW  - CRANIAL RADIATION
KW  - CHILDREN
KW  - CHILDHOOD
KW  - CHEMOTHERAPY
KW  - AGE
N2  - Purpose Posterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known.MethodsFour independent nonoverlapping retrospective cohorts of posterior fossa ependymomas (n = 820) were profiled using genome-wide methylation arrays. Risk stratification models were designed based on known clinical and newly described molecular biomarkers identified by multivariable Cox proportional hazards analyses. Results Molecular subgroup is a powerful independent predictor of outcome even when accounting for age or treatment regimen. Incompletely resected EPN_PFA ependymomas have a dismal prognosis, with a 5-year progression-free survival ranging from 26.1% to 56.8% across all four cohorts. Although first-line (adjuvant) radiation is clearly beneficial for completely resected EPN_PFA, a substantial proportion of patients with EPN_PFB can be cured with surgery alone, and patients with relapsed EPN_PFB can often be treated successfully with delayed external-beam irradiation. Conclusion The most impactful biomarker for posterior fossa ependymoma is molecular subgroup affiliation, independent of other demographic or treatment variables. However, both EPN_PFA and EPN_PFB still benefit from increased extent of resection, with the survival rates being particularly poor for subtotally resected EPN_PFA, even with adjuvant radiation therapy. Patients with EPN_PFB who undergo gross total resection are at lower risk for relapse and should be considered for inclusion in a randomized clinical trial of observation alone with radiation reserved for those who experience recurrence.
ER  -

RAMASWAMY, Vijay, Thomas HIELSCHER, Stephen C. MACK, Alvaro LASSALETTA, Tong LIN, Kristian W. PAJTLER, David T.W. JONES, Betty LUU, Florence M.G. CAVALLI, Kenneth ALDAPE, Marc REMKE, Martin MYNAREK, Stefan RUTKOWSKI, Sridharan GURURANGAN, Roger E. MCLENDON, Eric S. LIPP, Christopher DUNHAM, Juliette HUKIN, David D. EISENSTAT, Dorcas FULTON, Frank K. H. van LANDEGHEM, Mariarita SANTI, Marie-Lise C. van VEELEN, Erwin G. VAN MEIR, Satoru OSUKA, Xing FAN, Karin M. MURASZKO, Daniela P.C. TIRAPELLI, Sueli M. OBA-SHINJO, Suely K.N. MARIE, Carlos G. CARLOTTI, Ji Yeoun LEE, Amulya A. Nagesware RAO, Caterina GIANNINI, Claudia C. FARIA, Sofia NUNES, Jaume MORA, Ronald L. HAMILTON, Peter HAUSER, Nada JABADO, Kevin PETRECCA, Shin JUNG, Luca MASSIMI, Massimo ZOLLO, Giuseppe CINALLI, László BOGNÁR, Almos KLEKNER, Tibor HORTOBÁGYI, Sarah LEARY, Ralph P. ERMOIAN, James M. OLSON, Jeffrey R. LEONARD, Corrine GARDNER, Wieslawa A. GRAJKOWSKA, Lola B. CHAMBLESS, Jason CAIN, Charles G. EBERHART, Sama AHSAN, Maura MASSIMINO, Felice GIANGASPERO, Francesca R. BUTTARELLI, Roger J. PACKER, Lyndsey EMERY, William H. YONG, Horacio SOTO, Linda M. LIAU, Richard EVERSON, Andrew GROSSBACH, Tarek SHALABY, Michael GROTZER, Matthias A. KARAJANNIS, David ZAGZAG, Helen WHEELER, Katja von HOFF, Marta M. ALONSO, Teresa TUON, Ulrich SCHÜLLER, Karel ZITTERBART, Jaroslav ŠTĚRBA, Jennifer A. CHAN, Miguel GUZMAN, Samer K. ELBABAA, Howard COLMAN, Girish DHALL, Paul G. FISHER, Maryam FOULADI, Amar GAJJAR, Stewart GOLDMAN, Eugene HWANG, Marcel KOOL, Harshad LADHA, Elizabeth VERA-BOLANOS, Khalida WANI, Frank LIEBERMAN, Tom MIKKELSEN, Antonio M. OMURO, Ian F. POLLACK, Michael PRADOS, H. Ian ROBINS, Riccardo SOFFIETTI, Jing WU, Phillipe METELLUS, Uri TABORI, Ute BARTELS, Eric BOUFFET, Cynthia E. HAWKINS, James T. RUTKA, Peter DIRKS, Stefan M. PFISTER, Thomas E. MERCHANT, Mark R. GILBERT, Terri S. ARMSTRONG, Andrey KORSHUNOV, David W. ELLISON a Michael D. TAYLOR. Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis. \textit{Journal of Clinical Oncology}. Alexandria: American Society of Clinical Oncology, 2016, roč.~34, č.~21, s.~2468-2490. ISSN~0732-183X. Dostupné z: https://dx.doi.org/10.1200/JCO.2015.65.7825.

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