Glioma is a general term for a group of tumours that start in the supportive tissues (glial cells) of the brain or spinal cord. They are the most common type of primary brain tumours in adults and account for about 70% of all malignant (high-grade) tumours of the central nervous system (CNS).
Ependymoma is a type of glioma that starts in cells of the ependyma, which lines the ventricles (fluid-filled spaces or cavities that connect the brain to the spinal cord) and the centre of the spinal cord. These tumours account for about 2% of all brain and spinal cord tumours.
Based on the WHO grading system, ependymomas may be classified as low-grade to high-grade (grades I–III).
- Low-grade tumours (grades I and II) are more common in the spine.
- Myxopapillary ependymomas occur most often in people in their mid-30s.
- Subependymomas occur most often in middle-aged and elderly men.
- Most people have no symptoms.
- Treatment is usually based on the size of the tumour and if symptoms occur.
- Anaplastic ependymomas are high-grade tumours (grade III) that occur most often in the brain.
The following are treatment options for ependymoma (grades I, II and III). The types of treatments given are based on the unique needs of the person with cancer. There is no known effective chemotherapy for ependymoma.
- If surgery can be done, it is used as the main treatment to remove all of the tumour or as much of the tumour as is possible.
- radiation therapy
- External beam radiation therapy may be given:
- for grade I and II tumours, if the doctor knows or suspects some tumour remains after surgery
- after surgery for grade III (anaplastic) tumours
- Radiation therapy may be given to the entire brain and spinal cord (craniospinal irradiation or CSI) if tests show that the cancer has spread through the cerebrospinal fluid (CSF).
- It may also be used to treat recurrent tumours if radiation therapy was not given previously.
Supportive therapy is used to treat the symptoms caused by ependymomas. The following types of supportive therapy may be used:
- These drugs prevent seizures.
- They are given to people who have had a previous seizure.
- The most commonly used anticonvulsant is phenytoin (Dilantin).
- These drugs are used to reduce cerebral edema (buildup of fluid in the brain).
- The most commonly used corticosteroid is dexamethasone (Decadron).
People with ependymoma may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.