This protocol addresses infants younger than 12 months presenting with a newly diagnosed, localized intracranial WHO grade II or III ependymoma, with no evidence of cerebrospinal fluid (CSF) or spinal dissemination.
Patient age at diagnosis is the central driver of management decisions in this setting. In children younger than 12 months, chemotherapy alone is the recommended treatment strategy — radiotherapy is not administered upfront but is deferred. This differs from the approach used in older children, where radiotherapy typically plays an earlier role.
Following surgery, management in this population is built around a postoperative chemotherapy regimen, with radiotherapy withheld and deferred rather than delivered as part of the initial plan. The specific agents, schedule, and decision criteria for radiotherapy deferral are defined in the full protocol.
DOI: 10.1093/neuonc/nox166
Chemotherapy alone is an option in children less than 18 months old, while it is recommended in children aged less than 12 months.
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