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Treatment for ependymoma

 Men and women discussing brain tumours

This page is about the treatments for ependymoma brain tumours. There is information about

 

A quick guide to what's on this page

Treatment for ependymoma

Ependymomas can grow in the brain or in the spinal cord. They can also spread into the fluid that surrounds the brain (the cerebrospinal fluid or CSF). This means that ependymomas may spread into other areas of the lining of the brain and spinal cord. The main treatment is surgery to remove as much as possible of the tumour. It is sometimes possible to completely remove it. Some people have a course of radiotherapy afterwards to lower the risk of the ependymoma coming back.

If ependymoma comes back

If the ependymoma comes back after treatment, your specialist may suggest targeted radiotherapy if you didn't have radiotherapy before. Or they may suggest chemotherapy. These treatments can slow down the growth of the tumour and help to reduce symptoms.

Treatment in children under 3

Children under 3 are most likely to have surgery and then chemotherapy instead of radiotherapy. Radiotherapy is more likely to cause long term side effects in very young children. So doctors use chemotherapy to keep the tumour under control until they are around 3 years old and then give radiotherapy.

 

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Where ependymomas grow

Ependymomas can grow in the brain, or in the spinal cord.

Diagram showing the parts of the brain

They can be low grade or high grade (anaplastic). They can spread into the fluid that surrounds the brain, so sometimes may spread into other areas of the lining of the brain and spinal cord.

In children, ependymomas most often occur in the cerebellum (the back area of the brain) in a fluid filled space called the fourth ventricle. They may also occur in the cerebrum (marked as the forebrain in the diagram above) or least commonly in the spinal cord.

 

Main treatments for ependymoma

The main treatment is surgery to remove as much as possible of the tumour. It is sometimes possible to completely remove an ependymoma. Your doctor may recommend a course of radiotherapy after you have recovered from surgery. The radiotherapy is to lower the risk of the ependymoma coming back. 

If there is no sign of any ependymoma cells in the fluid around the brain and spinal cord (cerebrospinal fluid - CSF) have radiotherapy to the area that contained the tumour and the surrounding area. 

If there are cancer cells in the CSF your doctor is likely to recommend radiotherapy to the whole brain and spinal cord.

 

If ependymoma comes back

If the tumour comes back after treatment your specialist may recommend stereotactic radiotherapy to shrink the tumour. Or they may suggest chemotherapy. These treatments can slow down the growth of the tumour and help to reduce symptoms.

Your specialist will decide the exact treatment but it could include any of these drugs

Usually you would have a number of these drugs together as combination chemotherapy.

 

Children under 3

Children under the age of 3 are most likely to have chemotherapy instead of radiotherapy after surgery. If at all possible, cancer specialists don't like to treat children under 3 with radiotherapy. Their young age makes them more likely to develop long term radiotherapy side effects. So they use chemotherapy to keep a young child's tumour under control. The exact combination of drugs and the timing of treatment varies. Generally, your child is likely to have chemotherapy every 8 weeks for about a year.

 

Research into ependymoma

You can read about current research into ependymoma on the brain tumour research page.

 

More information about ependymoma

If you have questions about ependymoma treatment you may find information in our section about brain tumour treatment.

You can find information about the outlook (prognosis) for these tumours on the brain tumour statistics and outlook page

You are also welcome to contact the Cancer Research UK nurses on freephone 0808 800 4040. Lines are open from 9am to 5pm, Monday to Friday. 

You can contact one of the brain tumour organisations or look at our brain tumour reading list. If you want to find people to share experiences with online, you could use CancerChat, our online forum.

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Updated: 9 December 2013