Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Option Overview
Four types of standard treatment are used:
If the results of diagnostic tests show there may be a brain tumor, a biopsy is done by removing part of the skull and using a needle to remove a sample of the brain tissue. A pathologist views the tissue under a microscope to check for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery.
Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.
An MRI is often done after the tumor is removed to find out whether any tumor remains. If tumor remains, a second surgery to remove as much of the remaining tumor as possible may be done.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment to lower the risk that the cancer will come back after surgery is called adjuvant therapy.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of cancer being treated. Childhood ependymoma may be treated with fractionated radiation therapy, which divides the total dose of radiation into several smaller, equal doses delivered over a number of days.
External radiation therapy can be given in different ways:
- Three-dimensional (3D) conformal radiation therapy uses a computer to create a 3D picture of the tumor. The radiation beams are shaped to fit the tumor.
- Proton-beam therapy is a type of high-energy, external radiation therapy that uses streams of protons (small, positively-charged particles of matter) to kill tumor cells.
- Stereotactic radiosurgery is a type of radiation therapy that uses a head frame attached to the skull to keep the head still. A single large dose of radiation is aimed directly at the brain tumor. This causes less damage to nearby healthy tissue. Stereotactic radiosurgery is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery. This procedure does not involve surgery.