Treatment of WHO Grade II Ependymoma of the Spinal Cord
This protocol covers the clinical management of WHO grade II ependymoma arising in the spinal cord — a scenario in which the treatment pathway is shaped by the extent of surgical resection and, where needed, subsequent systemic intervention.
Clinical Scenario
In WHO grade II spinal cord ependymoma, initial management depends on what surgery achieves. After gross total resection, active surveillance (watch-and-wait) is the recommended approach. When resection is incomplete, postoperative local radiotherapy is indicated. Cases requiring further systemic treatment represent a distinct management step addressed in the full protocol.
Systemic Treatment — Partial Overview
When systemic pharmacological therapy is warranted, conventional oral chemotherapy is among the approaches that have been evaluated in recurrent intramedullary ependymoma. The complete selection of agents, sequencing criteria, and additional options are detailed in the full protocol.
References
DOI: 10.1093/neuonc/nox166In case of WHO grade II ependymomas following gross total resection, a watch-and-wait strategy is recommended.
In case of incomplete resection of a WHO grade II ependymoma, postoperative local radiotherapy is recommended with doses of 45–54 Gy.
Regarding conventional chemotherapy, a small study of 10 patients with recurrent intramedullary ependymoma has reported that continuous oral etoposide is well tolerated and may be active.
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