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Ependymoma (Spinal Cord Tumor) with Proton Therapy


Roman Sidenko, anaplastic ependymoma. Three years after proton therapy.


Four-year-old Roman Sidenko from Moscow was brought by his family for treatment at the MIBS Proton Therapy Center in the spring of 2019. Prior to this, as with most children entering the proton center, all the usual stages went through: a sudden deterioration in health, wandering parents in search of an accurate diagnosis, surgical removal of the tumor.


“Before the New Year, on December 28, Roman and his grandmother went to the circus. And on the way back she began to knit her leg. At first we thought it was an accident, and we decided to watch it on New Year's holidays, ”says the boy's mother, Alexander Sideenko .


However, the uncertainty in the gait increased in just two weeks, and immediately after the holidays, Sidenko rushed to the orthopedist. After examining the doctor, he did not find any "crime" and allowed Romka to go home. But it didn't get any better. Literally the next day, a neurologist, to whom the parents nevertheless decided to turn, suspected that something was wrong and called an ambulance.


In the Morozov City Children's Hospital, where Roman and his mother were brought by ambulance, the boy was given a head CT scan, and the picture clearly visualized a large formation on the back of the head. The boy was rushed to the hospital and was soon operated on, completely removing the tumor. A histological study gave an accurate answer to the question about the causes of the disease: a malignant neoplasm developing in the child's head, anaplastic ependymoma.


Ependymoma is a tumor of the brain and spinal cord, the third most common cancer of the central nervous system in children. It develops from cells lining the fluid-filled ventricles of the brain and the central canal of the spinal cord and is most common in children under 5 years of age.


In accordance with modern Russian and international protocols, it was necessary to undergo a course of radiation therapy after surgical removal of the tumor. “When we were discharged from the hospital, the doctor said that we needed radiation therapy, but he did not send us to a specific medical facility. My sister and I ourselves searched the Internet for the place where it would be better to go into radiation with a diagnosis of rheumatoid arthritis, and we found MIBS in St. Petersburg, ”says Alexandra.


“Roma came to us at the age of 4 with the diagnosis of anaplastic ependymoma of the left parieto-occipital region. Neurosurgeons removed the tumor, and after that the boy was given radiation therapy. Oncologist, radiotherapist MIBS Denis Andreevich Antipin says that despite complete removal of the tumor, there is a possibility that small residual components may be preserved along the perimeter of the bed after surgery. "The choice fell on proton therapy because it is currently the most cost-effective method of radiation therapy that can reduce the risk of secondary radiation-induced tumors while preserving human cognitive functions and minimizing the impact on surrounding healthy tissues."


In February-April 2019, Roman Sidenko underwent a seven-week treatment with protons and withstood all 33 radiation fractions (sessions) surprisingly well: no weakness, no nausea, and completely forgot about the problems at the end of the treatment. with his leg. After discharge, the boy was given dynamic observation, and Roman and his family were frequent guests of MIBS. St. Petersburg every three months to perform MRI of the head and back with contrast, according to a special protocol developed to assess the patient's condition after radiation therapy. They came to Petersburg. In the second year - every four months, then - every six months.


“Currently, the MRI images show a residual postoperative cavity throughout its periphery that is free of recurrence and tissue is actively accumulating contrast. And this is for the past 36 months, i.e. three years, Roman has been in remission, growing up, developing like an ordinary child, which makes us very happy. ”says Denis Antipin.


As my mother said, Roman is already finishing first grade, he is doing well with the program, although he does not like the Russian language very much. But he loves math and drawing - he even goes to the art studio. Only physical education exemption from restrictions is preserved so that the ball does not accidentally hit the head in play. But doctors do not forbid the pool, and Romka learns to swim with pleasure.


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