Treatment Option Overview for Childhood Ependymoma
Many of the improvements in survival in childhood cancer have been made as a result of clinical trials that have attempted to improve on the best available, accepted therapy. Clinical trials in pediatrics are designed to compare new therapy with therapy that is currently accepted as standard. This comparison may be done in a randomized study of two treatment arms or by evaluating a single new treatment and comparing the results with those previously obtained with existing therapy.
Because of the relative rarity of cancer in children, all patients with aggressive brain tumors should be considered for entry into a clinical trial. To determine and implement optimum treatment, treatment planning by a multidisciplinary team of cancer specialists who have experience treating childhood brain tumors is required. Radiation therapy of pediatric brain tumors is technically demanding and should be performed in centers that have experience in that area to ensure optimal results.
|Stage and/or Histopathologic Classification||Standard Treatment Options|
|Newly diagnosed childhood subependymoma||Surgery|
|Observation (in rare cases)|
|Newly diagnosed childhood myxopapillary ependymoma||Surgery with or without radiation therapy|
|Newly diagnosed childhood ependymoma (WHO Grade II) or anaplastic ependymoma (WHO Grade III):||Surgery|
|No residual disease, no disseminated disease||—Radiation therapy|
|Residual disease, no disseminated disease||—Second-look surgery|
|Central nervous system disseminated disease||—Radiation therapy|
|Children younger than 3 years||—Chemotherapy|
|Recurrent childhood ependymoma||Surgery|
|Radiation therapy and/or chemotherapy|