Klin Onkol 1997; 10(5): 139-142.
Ependymoma occurs most frenquently in children and young adults and accounts for about 10% of childhood primary central nervous system tumors. Typically they are more likely to arise in the posterior fossa. Ependymomas are locally invasive tumors with an incidence of spinal subarachnoid dissemination averaging 11% to 12%. Supratentorial tumors have a 3,5-8% overall incidence of such spread, where as infratentorially located tumors have rate of 20% to 33%. Surgery and radiotherapy remain the standard treatment. Post-operative radiation therapy is recognized as a standard treatment for malignant ependymomas. The appropriate treatment volume remains a major question in radiation therapy for ependymomas. Local radiation doses of 45 Gy to 55 Gy are needed to establish reliable local control. For high-grade ependymomas craniospinal prophylactic irradiation is generally recommended. For low-grade supratentorial ependymoma local field irradiationis recommended, for low-grade infratentorial ependymomas craniospinal irradiation is recommended only when the cerebrospinal fluid shows cytologic or myelographic evidence of seeding. Older age, higher local radiation dose, histologic grade, and complete tumor resections is seen to be the only favorable prognostic factors.
