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Child's Nervous System
Erschienen in: Child's Nervous System 10/2009

01.10.2009 | Invited Paper

Management strategies for recurrent ependymoma in the paediatric population

verfasst von: M. Sangra, N. Thorp, P. May, B. Pizer, C. Mallucci

Erschienen in: Child's Nervous System | Ausgabe 10/2009

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Abstract

Introduction

The management of recurrent ependymoma within the paediatric population remains a therapeutic challenge. The options available are varied and patients may have already received prior radio- or chemotherapy. As yet, no consensus exists regarding their optimal treatment. We review the literature and present our contemporary management strategies for this interesting group of patients.

Results and discussion

Survival following recurrence is poor and those prognostic factors that predispose to recurrence include extent of surgical resection and the timing of administration of adjuvant therapy. The extent of resection at re-operation can confer a survival advantage, without a necessary increase in morbidity. Strategies aimed at improving surgical resection at first diagnosis include improving and centralising post-surgical radiological review, defining what are true residuals, and centralising surgical review of incompletely resected tumours. Re-irradiation can improve survival, and with the use of conformal radiation fields need not necessarily lead to neuropsychological damage. Cisplatin and etoposide remain the most effective chemotherapeutic agents to date and with an increase in the understanding of tumour biology this may improve further. Because of the complex nature of this group of patients, decisions regarding their management require the involvement of a paediatric neurosurgeon, paediatric neuro-oncologist and paediatric radiation oncologist.
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Metadaten
Titel
Management strategies for recurrent ependymoma in the paediatric population
verfasst von
M. Sangra
N. Thorp
P. May
B. Pizer
C. Mallucci
Publikationsdatum
01.10.2009
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 10/2009
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-0914-7

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