Treatment of Newly Diagnosed Localized Cerebral Ependymoma in a Child Aged 12–18 Months
This protocol addresses the management of intracranial WHO grade II or III ependymoma newly diagnosed in children between 12 and 18 months of age, staged as localized disease with no evidence of cerebrospinal fluid (CSF) or spinal dissemination.
Clinical Scenario
The patient is a child aged 12 to 18 months with a newly diagnosed, localized intracranial ependymoma (WHO grade II or III). Staging has excluded CSF spread and spinal involvement. The patient's age at diagnosis is a defining factor in the treatment approach and distinguishes this population from older children and adults.
Treatment Approach (Partial Overview)
The initial management centers on surgical intervention directed at obtaining a histological diagnosis, with the extent of resection serving as a central surgical objective. Further management decisions — including criteria for additional surgical intervention — depend on postoperative imaging findings.
The complete protocol, including all decision points and management steps, is available below.
References
DOI: 10.1093/neuonc/nox166
- Resection is recommended to obtain a histological diagnosis and should be a gross total resection whenever feasible.
- A second-look surgery should be considered when residual tumor is demonstrated on postoperative MRI and gross total resection is a realistic goal.
- Postoperative conformal radiotherapy with doses of 54 Gy is recommended in children between 12 months and 18 months or in older children with poor neurological status.
View source ↗