Ependymoma

Ependymoma is a childhood brain tumour that starts in the lining of the ventricles of the brain. They happen most often in the cerebellum. They can also happen in the upper brain and sometimes in the spinal cord. They usually don't grow into nearby normal brain tissue.

The World Health Organization (WHO) groups ependymal tumours into subtypes:

• subependymoma (grade 1)
• myxopapillary ependymomas (grade 2)
• ependymoma (grade 2 and grade 3)

The healthcare team will suggest treatments based on your child's needs and work with you to develop a treatment plan. Treatments for ependymomas depends on:

• the subtype of ependymoma
• the location of the tumour
• how far the tumour has grown or spread
• if the tumour can be surgically removed (resectable)
• your child's age, neurological condition and general health

Newly diagnosed ependymomas are commonly treated with surgery and radiation therapy. Chemotherapy is sometimes used.

Recurrent ependymomas are tumours that have come back after treatment. They may be treated with surgery, radiation therapy (if not already given) and chemotherapy. Doctors may recommend treatments offered through a clinical trial.

Whenever possible, surgery is used to treat ependymomas. The goal is to remove as much of the tumour as possible. Surgery is usually followed with radiation therapy. If all of the tumour is not removed with surgery, second-look surgery may be used. Second-look surgery is used to see how treatment worked and to remove more of the tumour, if possible. It can be done a few days after the first surgery or after chemotherapy. Surgery may be used to relieve a buildup of cerebrospinal fluid (CSF).

Find out more about surgery for childhood brain and spinal cord tumours.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation therapy is usually given after surgery to prevent cancer from coming back (recurring). The entire brain and spinal cord may be treated with low-dose radiation (called craniospinal radiation). In some cases of myxopapillary ependymoma (grade 2), radiation therapy may not be needed after surgery.

Whenever possible, doctors avoid giving radiation to children younger than 3 years of age because of its long-term effects on developing brain cells.

Find out more about radiation therapy for childhood brain and spinal cord tumours.

Chemotherapy uses drugs to destroy cancer cells. It is not usually effective alone against ependymomas, so it is used in combination with radiation therapy. It may also be used to delay radiation therapy in certain cases, such as when the child is younger than 3 years of age. Chemotherapy may also be given after surgery to shrink any tumour left behind and increase the possibility of being able to remove the tumour in second-look surgery.

The most common chemotherapy drugs used include:

• vincristine (Oncovin)
• cisplatin
• cyclophosphamide
• etoposide (Vepesid)

Find out more about chemotherapy for childhood brain and spinal cord tumours.

Children with cancer may be treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.