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==Overview==
==Overview==
 
The predominant therapy for ependymoma is surgical resection. Adjunctive chemoradiation may be required.
==Medical Therapy==
==Chemotherapy==
* The malignant (anaplastic) varieties of this [[tumor]], malignant ependymoma and the ependymoblastoma, are treated similarly to [[medulloblastoma]] but the prognosis is much less favorable. Malignant ependymomas may be treated with a combination of radiation therapy and chemotherapy.
*There is no evidence to date that adjuvant chemotherapy, including the use of myeloablative chemotherapy, improves the outcome for patients with totally resected, nondisseminated ependymoma.<ref name="pmid16874765">{{cite journal| author=Zacharoulis S, Levy A, Chi SN, Gardner S, Rosenblum M, Miller DC et al.| title=Outcome for young children newly diagnosed with ependymoma, treated with intensive induction chemotherapy followed by myeloablative chemotherapy and autologous stem cell rescue. | journal=Pediatr Blood Cancer | year= 2007 | volume= 49 | issue= 1 | pages= 34-40 | pmid=16874765 | doi=10.1002/pbc.20935 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16874765  }} </ref>
*Current treatment approaches do not include chemotherapy as a standard component of primary therapy for children with newly diagnosed ependymomas that are completely resected.
*[[Etoposide]] may be used in recurrent cases.


==Radiation Therapy==
==Radiation Therapy==
* For this reason, well-differentiated ependymomas are usually treated with [[radiation therapy]] only.  Ependymoblastomas, which occur in infants and children younger than 5 years of age, may spread through the [[cerebrospinal fluid]] and usually require radiation therapy. The subependymoma, a variant of the ependymoma, arises in the fourth ventricle but may occur in the [[septum pellucidum]] and the cervical [[spinal cord]].
*Radiation therapy consisting of 54 [[gray]] to 55.8 [[gray]] is recommended for children aged 3 years and older who are diagnosed with well-differentiated ependymomas.<ref name=Cancergov> Ependymoma treatment. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_48 URL Accessed on 10/13/2015.</ref>
*It is not necessary to treat the entire [[CNS]] (whole [[brain]] and [[spine]]) because these tumors usually recur initially at the local site.
*When possible, patients should be treated in a center experienced with the delivery of highly conformal [[radiation therapy]] (including intensity-modulated radiation therapy or charged-particle radiation therapy) to pediatric patients with [[brain tumor]]s.


==References==
==References==
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Latest revision as of 22:19, 26 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

The predominant therapy for ependymoma is surgical resection. Adjunctive chemoradiation may be required.

Chemotherapy

  • There is no evidence to date that adjuvant chemotherapy, including the use of myeloablative chemotherapy, improves the outcome for patients with totally resected, nondisseminated ependymoma.[1]
  • Current treatment approaches do not include chemotherapy as a standard component of primary therapy for children with newly diagnosed ependymomas that are completely resected.
  • Etoposide may be used in recurrent cases.

Radiation Therapy

  • Radiation therapy consisting of 54 gray to 55.8 gray is recommended for children aged 3 years and older who are diagnosed with well-differentiated ependymomas.[2]
  • It is not necessary to treat the entire CNS (whole brain and spine) because these tumors usually recur initially at the local site.
  • When possible, patients should be treated in a center experienced with the delivery of highly conformal radiation therapy (including intensity-modulated radiation therapy or charged-particle radiation therapy) to pediatric patients with brain tumors.

References

  1. Zacharoulis S, Levy A, Chi SN, Gardner S, Rosenblum M, Miller DC; et al. (2007). "Outcome for young children newly diagnosed with ependymoma, treated with intensive induction chemotherapy followed by myeloablative chemotherapy and autologous stem cell rescue". Pediatr Blood Cancer. 49 (1): 34–40. doi:10.1002/pbc.20935. PMID 16874765.
  2. Ependymoma treatment. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_48 URL Accessed on 10/13/2015.

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