Ependymoma Guidelines

Updated: Jul 21, 2021
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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Guidelines Summary

The National Comprehensive Cancer Network (NCCN) recommends the following for treatment of adults with ependymoma [9] :

  • After a gross total resection (GTR) of an intracranial WHO grade II ependymoma, limited field fractionated external beam radiotherapy (LFFEBRT) can be considered versus mere observation.
  • Postoperative LFFEBRT for WHO grade II ependymoma when subtotal resection is noted on postoperative MRI, and for grade III anaplastic ependymoma regardless of the extent of resection.  
  • If postoperative spinal MRI or LP findings are positive, craniospinal radiation therapy is indicated regardless of grade or extent of resection.
  • For recurrent ependymoma, patients who have not received radiation therapy should receive radiation therapy, and if a patient has received radiation therapy, then chemotherapy, radiation therapy, or supportive care should be considered.