An ependymoma is a tumor located in the cerebrospinal fluid-filled spaces of the brain and/or spinal cord. According to the Childhood Brain Tumor Foundation, ependymomas are rare but they're the third most common type of brain tumor found in children. The average age of diagnosis is at 4 to 6 years, but they can also be diagnosed in adults, most commonly in adults in their 40s and 50s.
Surgery
The first line of treatment is surgery to remove as much of the tumor as possible without harming healthy tissue. Removal of the entire tumor is associated with a good prognosis, but that's only possible in about 30 to 40 percent of the cases because essential brain or spine tissue might be damaged during excision of the tumor.
Radiation
Radiation treatment is not recommended for children younger than 3 because it can affect development. Even when post-operative scans indicate that the entire tumor was removed, surgery is typically followed by radiation therapy to ensure any stray tumor cells are destroyed. Radiation is usually targeted to the site of the tumor because recurring ependymomas almost always arise at the same location. However, if examination of the spinal fluid indicates the tumor has spread, then doctors may consider radiation to the entire brain and spinal cord.
Conformal radiation therapy targets the tumor by creating a 3D image on a computer and using that to shape the beams. Another type of radiation therapy that keeps the radiation away from healthy tissue is called stereotactic radiation therapy. This uses a frame attached to the skull to be sure radiation beams are aimed directly at the tumor.
Chemotherapy
According to the Childhood Brain Tumor Foundation, the use of chemotherapy is not a straightforward choice. It is usually used only if tumor still remains after surgery and for children who are younger than 3 who should not have radiation therapy. Even though chemotherapy shrinks the tumor, it doesn't always result in improved survival rates. Considering the potential for severe side effects, such as kidney damage and hearing loss, combined with questionable results, it is unclear whether chemotherapy is a good choice.
Clinical Trials
Clinical trials are constantly being conducted to find new treatments for ependymoma and may be a good option if the tumor is resistant to treatment or recurs. Participants in clinical trials may receive new treatment or they may be part of a group that is only receiving standard treatment. You can learn about them by asking your oncologist and by searching the clinical trials page on the National Cancer Institute website (see Resources).
