Ependymomas are a type of glioma that starts in cells of the ependyma. The ependyma lines the fluid-filled spaces in the ventricles (cavities) of the brain and the centre of the spinal cord. Ependymomas spread to the cerebrospinal fluid more often than other gliomas. They do not spread outside the brain or spinal cord.
Based on the World Health Organization (WHO) grading system, ependymomas are classified as low to high grade (grades 1–3).
Low-grade tumours (grade 1 and grade 2) are more common in the spine. Anaplastic ependymomas are high-grade tumours (grade 3) that occur most often in the brain.
Treatment is usually based on the size of the tumour and if symptoms occur. The following are treatments for all grades of ependymoma:
Surgery may be done to remove all of the tumour or as much of the tumour as possible. Low-grade tumours may not need further treatment if the entire tumour can be removed.
Radiation therapy may be given after surgery for grade 1 and 2 tumours if the tumours can’t be completely removed. Radiation therapy is given after surgery for anaplastic tumours. It may also be used to treat tumours that come back after treatment (called recurrent ependymomas) if radiation therapy was not given previously. It may be given to the entire brain and spinal cord if tests show that the cancer has spread through the cerebrospinal fluid.
Corticosteroids and antiseizure medicines (anticonvulsants) @(Model.HeadingTag)>
Other medicines used for people with brain tumours do not treat the tumour but help treat symptoms caused by the tumour or the treatments.
- Corticosteroids help lessen the swelling around the brain tumour and may relieve headaches and other symptoms. A commonly used corticosteroid is dexamethasone (Decadron, Dexasone).
- Antiseizure medicines (anticonvulsants) are given to prevent seizures. They are usually not given unless the tumour has caused seizures. A commonly used antiseizure drug is phenytoin (Dilantin).
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American Cancer Society. Brain and Spinal Cord Tumors in Adults. 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003088-pdf.pdf.
American Society of Clinical Oncology. Brain Tumor. 2015: http://www.cancer.net/cancer-types/brain-tumor/view-all.
Chang S, Mehta M, Vogelbaum M, Taylor M, Ahluwalia M . Neoplasms of the central nervous system. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 97:1412-1455.
National Cancer Institute. Adult Central Nervous System Tumors Treatment for Health Professionals (PDQ®). 2016: http://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq#section/all.