A study by the Jacksonville and the MGH groups published in the Red Journal reporting the experience of these two centers in treating pediatric ependymoma of the spinal cord with PBT. 14 pediatric patients with non-metastatic non-myxopapillary grade II (n=6) and grade III (n=8) spinal ependymoma including five tumors within the cervical cord, 3 within the thoracic cord, and 6 within the lumbosacral cord, were treated to a total dose of 50.4 Gy (n=8), 52.2 (n=1), or 54 Gy (n=5). With a median follow-up of 6.3 years, this study reported no tumors progressed; 1 patient developed additional neurologic deficits following radiation, 1 case of grade 2 erectile dysfunction and 2 cases of musculoskeletal toxicity; no patient had developed cardiac, pulmonary, or other visceral organ complications, nor a second malignancy. The authors concluded that a total dose of 50-54 Gy can be safely delivered and plays a beneficial role in the multidisciplinary management of children with non-myxopapillary spinal cord ependymoma. Proton therapy may reduce late radiation effects and is not associated with unexpected spinal cord toxicity. <br />
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