Treatment of WHO Grade III (Anaplastic) Ependymoma of the Spinal Cord

WHO grade III (anaplastic) ependymoma of the spinal cord is a specific high-grade clinical scenario with distinct management considerations. This page outlines the key context and directs you to the full structured treatment protocol.

Clinical Scenario

This protocol applies to patients with WHO grade III (anaplastic) ependymoma of the spinal cord. At this grade, postoperative radiotherapy is recommended regardless of the extent of surgical resection — a consideration that shapes the broader treatment pathway.

Treatment Approach

When systemic therapy is considered in this setting, oral chemotherapy is among the approaches that have been evaluated — with evidence from small patient cohorts suggesting tolerability and potential activity.

The complete regimen, full range of options, selection criteria, and sequencing are available in the protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/neuonc/nox166

In case of WHO grade III (anaplastic) ependymomas, postoperative radiotherapy with doses of 45–54 Gy is recommended regardless of the extent of resection.
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.
Bevacizumab can provide clinical benefit in some patients, although the changes on MRI do not meet the current criteria for radiological tumor response.

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