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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65742_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65742_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65742_"><span class="title" itemprop="name">Childhood Ependymoma Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Pediatric Treatment Editorial Board</span>.</p><p class="small">Published online: September 22, 2017.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062971__305">This PDQ cancer information summary has current information about the treatment of childhood ependymoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062971__306">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.</p></div><div id="CDR0000062971__73"><h2 id="_CDR0000062971__73_">General Information About Childhood Ependymoma</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062971__74">Childhood ependymoma is a disease in which malignant (cancer)
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cells form in the tissues of the brain and spinal cord.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__278">There are different types of ependymomas.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__211">The part of the brain that is affected depends on where the ependymoma forms.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__151">The cause of most childhood brain tumors is unknown.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__80">The signs and symptoms of childhood ependymoma are not the same in every child.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__84">Tests that examine the brain and spinal cord are used to detect
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(find) childhood ependymoma.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__145">Childhood ependymoma is diagnosed and removed in surgery.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__88">Certain factors affect prognosis (chance of
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recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062971__74"><h3>Childhood ependymoma is a disease in which malignant (cancer)
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cells form in the tissues of the brain and spinal cord.</h3><p id="CDR0000062971__76">The brain controls <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046649/" class="def">vital</a> functions such as memory and learning, emotion, and the
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senses (hearing, sight, smell, taste, and touch). The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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is made up of bundles of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerve</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fibers</a> that connect the brain with nerves in
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most parts of the body.</p><p id="CDR0000062971__77"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">Ependymomas</a> form from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000540760/" class="def">ependymal cells</a> that line the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045939/" class="def">ventricles</a> and passageways in the brain and the spinal cord. Ependymal cells make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a> (CSF). </p><p id="CDR0000062971__78">This summary is about the treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary</a> brain tumors (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that begin in the
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brain). Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a>
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brain tumors, which are
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tumors that
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begin in other parts of the body and spread to the brain, is not discussed in
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this summary. </p><p id="CDR0000062971__79">There are many different types of brain tumors. Brain tumors can occur in both children and adults. However,
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treatment for children is different than treatment for adults. See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information:</p><ul id="CDR0000062971__167"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257997/">Childhood Brain and Spinal Cord Tumors Treatment Overview</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062697/">Adult Central Nervous System Tumors Treatment</a></div></li></ul></div><div id="CDR0000062971__278"><h3>There are different types of ependymomas.</h3><p id="CDR0000062971__254">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454794/" class="def">World Health Organization</a> (WHO) groups ependymal tumors into five main subtypes:</p><ul id="CDR0000062971__255"><li class="half_rhythm"><div>Subependymoma (WHO Grade I).</div></li><li class="half_rhythm"><div>Myxopapillary ependymoma (WHO Grade I).</div></li><li class="half_rhythm"><div>Ependymoma (WHO Grade II).</div></li><li class="half_rhythm"><div><i>RELA</i> fusion–positive ependymoma (WHO Grade II or Grade III with change in the <i>RELA</i>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a>).</div></li><li class="half_rhythm"><div>Anaplastic ependymoma (WHO Grade III).</div></li></ul><p id="CDR0000062971__280">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of a tumor describes how <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> the cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> look under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> and how quickly the tumor is likely to grow and spread. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">Low-grade</a> (Grade I) cancer cells look more like normal cells than <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">high-grade</a> cancer cells (Grade II and III). They also tend to grow and spread more slowly than Grade II and III cancer cells.</p></div><div id="CDR0000062971__211"><h3>The part of the brain that is affected depends on where the ependymoma forms.</h3><p id="CDR0000062971__213">Ependymomas can form anywhere in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a>-filled ventricles and passageways in the brain and spinal cord. Most ependymomas form in the fourth ventricle and affect the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046714/" class="def">cerebellum</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046491/" class="def">brain stem</a>. <div id="CDR0000062971__296" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20inside%20of%20the%20brain%20showing%20the%20lateral%20ventricle%2C%20third%20ventricle%2C%20fourth%20ventricle%2C%20and%20the%20passageways%20between%20the%20ventricles%20(with%20cerebrospinal%20fluid%20shown%20in%20blue)&p=BOOKS&id=453504_CDR0000757890.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65742.5/bin/CDR0000757890.jpg" alt="Drawing of the inside of the brain showing the lateral ventricle, third ventricle, fourth ventricle, and the passageways between the ventricles (with cerebrospinal fluid shown in blue). Other parts of the brain shown include the cerebrum, cerebellum, spinal cord, and brain stem (pons and medulla)." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the inside of the brain showing the lateral ventricle, third ventricle, fourth ventricle, and the passageways between the ventricles (with cerebrospinal fluid shown in blue). Other parts of the brain shown include the cerebrum, cerebellum, spinal cord, and brain stem (pons and medulla).</p></div></div></p><p id="CDR0000062971__297">Once an ependymoma forms, areas of the brain that may be affected include:
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</p><ul id="CDR0000062971__214"><li class="half_rhythm"><div><b>Cerebrum</b>: The largest part of the brain, at the top of the head. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046484/" class="def">cerebrum</a> controls thinking, learning, problem-solving, speech, emotions, reading, writing, and voluntary movement. </div></li><li class="half_rhythm"><div><b>Cerebellum</b>: The lower, back part of the brain (near the middle of the back of the head). The cerebellum controls movement, balance, and posture. </div></li><li class="half_rhythm"><div><b>Brain stem</b>: The part that connects the brain to the spinal cord, in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748353/" class="def">heart rate</a>, and the nerves and muscles used in seeing, hearing, walking, talking, and eating.</div></li><li class="half_rhythm"><div><b>Spinal cord</b>: The column of nerve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membranes</a>. The spinal cord and membranes are surrounded by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415916/" class="def">vertebrae</a> (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch. </div></li></ul></div><div id="CDR0000062971__151"><h3>The cause of most childhood brain tumors is unknown.</h3></div><div id="CDR0000062971__80"><h3>The signs and symptoms of childhood ependymoma are not the same in every child.</h3><p id="CDR0000062971__303"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">Signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> depend on the following:</p><ul id="CDR0000062971__304"><li class="half_rhythm"><div>The child's age.</div></li><li class="half_rhythm"><div>Where the tumor has formed.</div></li></ul><p id="CDR0000062971__82">Signs and symptoms may be
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caused by childhood ependymoma or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>. Check with your child's doctor if your child has any of the following:</p><ul id="CDR0000062971__83"><li class="half_rhythm"><div>Frequent headaches.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045484/" class="def">Seizures</a>.</div></li><li class="half_rhythm"><div>Nausea and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>.</div></li><li class="half_rhythm"><div>Pain or stiffness in the neck.</div></li><li class="half_rhythm"><div>Loss of balance or trouble walking.</div></li><li class="half_rhythm"><div>Weakness in the legs.</div></li><li class="half_rhythm"><div>Blurry vision.</div></li><li class="half_rhythm"><div>Back pain.</div></li><li class="half_rhythm"><div>A change in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446980/" class="def">bowel function</a>.</div></li><li class="half_rhythm"><div>Trouble <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urinating</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450096/" class="def">Confusion</a> or irritability.</div></li></ul></div><div id="CDR0000062971__84"><h3>Tests that examine the brain and spinal cord are used to detect
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(find) childhood ependymoma.</h3><p id="CDR0000062971__86">The following tests and procedures may be used:</p><ul id="CDR0000062971__87"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322871/" class="def">Neurological exam</a></b>: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging) with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413947/" class="def">gadolinium</a></b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the bloodstream. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046303/" class="def">Lumbar puncture</a></b>: A procedure used to collect cerebrospinal fluid (CSF) from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000396787/" class="def">spinal column</a>. This is done by placing a needle between two bones in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a> and into the CSF around the spinal cord and removing a sample of fluid. The sample of CSF is checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for signs of tumor cells. The sample may also be checked for the amounts of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a>. A higher than normal amount of protein or lower than normal amount of glucose may be a sign of a tumor. This procedure is also called an LP or spinal tap.<div id="CDR0000062971__242" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Lumbar%20puncture&p=BOOKS&id=453504_CDR0000503953.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65742.5/bin/CDR0000503953.jpg" alt="Lumbar puncture; drawing shows a patient lying in a curled position on a table and a spinal needle (a long, thin needle) being inserted into the lower back. Inset shows a close-up of the spinal needle inserted into the cerebrospinal fluid (CSF) in the lower part of the spinal column." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing.</p></div></div></div></li></ul></div><div id="CDR0000062971__145"><h3>Childhood ependymoma is diagnosed and removed in surgery.</h3><p id="CDR0000062971__147">If the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689569/" class="def">diagnostic tests</a> show there may be a brain tumor, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> is done by removing part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> and using a needle to remove a sample of the brain tissue. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. </p><div id="CDR0000062971__241" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Craniotomy%3A%20An%20opening%20is%20made%20in%20the%20skull%20and%20a%20piece%20of%20the%20skull%20is%20removed%20to%20show%20part%20of%20the%20brain&p=BOOKS&id=453504_CDR0000691155.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65742.5/bin/CDR0000691155.jpg" alt="Drawing of a craniotomy showing a section of the scalp that has been pulled back to remove a piece of the skull; the dura covering the brain has been opened to expose the brain. The layer of muscle under the scalp is also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.</p></div></div><p id="CDR0000062971__298">The following test may be done on the tissue that was removed:</p><ul id="CDR0000062971__299"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A test that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> in a sample of tissue. The antibody is usually linked to a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045624/" class="def">brain stem glioma</a> and other brain tumors. </div></li></ul><p id="CDR0000062971__300">An MRI is often done after the tumor is removed to find out whether any tumor remains.</p></div><div id="CDR0000062971__88"><h3>Certain factors affect prognosis (chance of
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recovery) and treatment options.</h3><p id="CDR0000062971__158">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on:</p><ul id="CDR0000062971__159"><li class="half_rhythm"><div>Where the tumor has formed in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046481/" class="def">central nervous system</a> (CNS).</div></li><li class="half_rhythm"><div>Whether there are certain changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosomes</a>.</div></li><li class="half_rhythm"><div>Whether any cancer cells remain after surgery to remove the tumor.
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</div></li><li class="half_rhythm"><div>The type of ependymoma.
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</div></li><li class="half_rhythm"><div>The age of the child when the tumor is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>.
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</div></li><li class="half_rhythm"><div>Whether the cancer has spread to other parts of the brain or spinal cord.
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</div></li><li class="half_rhythm"><div>Whether the tumor has just been diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).
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</div></li></ul><p id="CDR0000062971__283">Prognosis also depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> that is given.</p></div></div><div id="CDR0000062971__91"><h2 id="_CDR0000062971__91_">Stages of Childhood Ependymoma</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062971__202">The area where the tumor is found and the child’s age are used in place of a staging system to plan cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__207">The information from tests and procedures done to detect (find) childhood ependymoma is used to plan cancer treatment.</a></div></li></ul></div><div id="CDR0000062971__202"><h3>The area where the tumor is found and the child’s age are used in place of a staging system to plan cancer treatment.</h3><p id="CDR0000062971__204"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">Staging</a> is the process used to find out how much <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> there is and if cancer has spread. There is no standard <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689095/" class="def">staging system</a> for childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a>. Treatment is based on where the cancer is in the body and the age of the child.
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</p></div><div id="CDR0000062971__207"><h3>The information from tests and procedures done to detect (find) childhood ependymoma is used to plan cancer treatment.</h3><p id="CDR0000062971__209">Some of the tests used to detect childhood ependymoma are repeated after the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is removed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. (See the <a href="#CDR0000062971__84">General Information</a> section.) This is to find out how much tumor remains after surgery. </p></div></div><div id="CDR0000062971__94"><h2 id="_CDR0000062971__94_">Recurrent Childhood Ependymoma</h2><p id="CDR0000062971__95"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a> childhood
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> is a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> that has recurred (come back)
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after it has been treated. Childhood ependymoma commonly recurs, usually at the
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original <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> site. The tumor may
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come back as long as 15 years or more after initial treatment. </p></div><div id="CDR0000062971__96"><h2 id="_CDR0000062971__96_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062971__97">There are different types of treatment for children with
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ependymoma. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__101">Children with ependymoma should have their treatment planned by
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a team of health care providers who are experts in treating childhood brain tumors.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__199">Childhood brain and spinal cord tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__190">Some cancer treatments cause side effects months or years
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after treatment has ended.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__105">Four types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062971__107">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__112">Radiation therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__116">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__301">Observation</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062971__119">New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__180">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__182">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062971__184">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062971__97"><h3>There are different types of treatment for children with
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ependymoma. </h3><p id="CDR0000062971__99">Different types of treatment are available for children with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a>. Some treatments are
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment
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clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or
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obtain information on new treatments for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that
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a new treatment is better than the standard
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treatment, the new treatment may become the standard
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treatment.</p><p id="CDR0000062971__100">Because cancer in children is rare, taking part in a clinical trial
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should be considered. Some clinical trials are open only to patients who have not started treatment. </p></div><div id="CDR0000062971__101"><h3>Children with ependymoma should have their treatment planned by
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a team of health care providers who are experts in treating childhood brain tumors.</h3><p id="CDR0000062971__103">Treatment will be overseen by a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000693555/" class="def">pediatric oncologist</a>, a doctor who specializes
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in treating children with cancer. The pediatric oncologist works with
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other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046245/" class="def">pediatric</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000650566/" class="def">health care providers</a> who are experts in treating children
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with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain tumors</a> and who specialize
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in certain areas of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a>. These may include the following
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478785/" class="def">specialists</a>:</p><ul id="CDR0000062971__104"><li class="half_rhythm"><div>Pediatric <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046269/" class="def">neurosurgeon</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046267/" class="def">Neurologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318818/" class="def">Neuropathologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318819/" class="def">Neuroradiologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000757278/" class="def">Pediatrician</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318825/" class="def">Rehabilitation specialist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046546/" class="def">Radiation
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oncologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046290/" class="def">Medical
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oncologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046439/" class="def">Endocrinologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044716/" class="def">Psychologist</a>.</div></li></ul></div><div id="CDR0000062971__199"><h3>Childhood brain and spinal cord tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years.</h3><p id="CDR0000062971__201">
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Childhood brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> that continue for months or years. Signs or symptoms caused by the tumor may begin before <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosis</a>. Signs or symptoms caused by treatment may begin during or right after treatment.</p></div><div id="CDR0000062971__190"><h3>Some cancer treatments cause side effects months or years
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after treatment has ended.</h3><p id="CDR0000062971__192">These are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390292/" class="def">late effects</a>. Late effects of cancer treatment may include the following:</p><ul id="CDR0000062971__193"><li class="half_rhythm"><div>Physical problems.</div></li><li class="half_rhythm"><div>Changes in mood, feelings, thinking, learning, or memory.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046658/" class="def">Second cancers</a> (new types of cancer).</div></li></ul><p id="CDR0000062971__194">Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a> for more information).
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</p></div><div id="CDR0000062971__105"><h3>Four types of standard treatment are used:</h3><div id="CDR0000062971__107"><h4>Surgery </h4><p id="CDR0000062971__150">If the results of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689569/" class="def">diagnostic tests</a> show there may be a brain tumor, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> is done by removing part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> and using a needle to remove a sample of the brain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to check for cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery. <div id="CDR0000062971__295" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Craniotomy%3A%20An%20opening%20is%20made%20in%20the%20skull%20and%20a%20piece%20of%20the%20skull%20is%20removed%20to%20show%20part%20of%20the%20brain&p=BOOKS&id=453504_CDR0000691155.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65742.5/bin/CDR0000691155.jpg" alt="Drawing of a craniotomy showing a section of the scalp that has been pulled back to remove a piece of the skull; the dura covering the brain has been opened to expose the brain. The layer of muscle under the scalp is also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.</p></div></div></p><p id="CDR0000062971__294">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> 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.</p><p id="CDR0000062971__215">Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> 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 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.
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</p></div><div id="CDR0000062971__112"><h4>Radiation therapy
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</h4><p id="CDR0000062971__149">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy: </p><ul id="CDR0000062971__307"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following:<dl id="CDR0000062971__308" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">Conformal radiation therapy</a>: Conformal radiation therapy is a type of external radiation therapy that uses a computer to make a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the tumor and shapes the radiation beams to fit the tumor.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT): IMRT is a type of 3-dimensional (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">Proton-beam radiation therapy</a>: Proton-beam therapy is a type of high-energy, external radiation therapy. A radiation therapy machine aims streams of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044715/" class="def">protons</a> (tiny, invisible, positively-charged particles) at the cancer cells to kill them.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">Stereotactic radiosurgery</a>: Stereotactic radiosurgery is a type of external radiation therapy. A rigid head frame is attached to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> to keep the head still during the radiation treatment. A machine aims a single large <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation directly at the tumor. This procedure does not involve surgery. It is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000062971__309">The way the radiation therapy is given depends on the type of cancer being treated. External radiation therapy is used to treat childhood ependymoma. </p><p id="CDR0000062971__115">Children younger than 3 years who receive radiation therapy to the brain have a higher risk of problems with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000637716/" class="def">growth and development</a> than older children. 3-D conformal radiation therapy and proton-beam therapy are being studied in children younger than 3 years to see if the effects of radiation on growth and development are lessened.</p></div><div id="CDR0000062971__116"><h4>Chemotherapy </h4><p id="CDR0000062971__118">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). The way the chemotherapy is given depends on the type of cancer being treated.</p></div><div id="CDR0000062971__301"><h4>Observation</h4><p id="CDR0000062971__186"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">Observation</a> is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until signs or symptoms appear or change. Observation may be used to treat a child with a subependymoma who has no symptoms and whose tumor is found while treating another condition.</p></div></div><div id="CDR0000062971__119"><h3>New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000062971__122">This summary section describes treatments that are being studied in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. It may not mention every new treatment being studied. Information about clinical trials is available from the
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<a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000062971__310"><h4>Targeted therapy</h4><p id="CDR0000062971__312"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to attack cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.</p><p id="CDR0000062971__313">Targeted therapy is being studied for the treatment of childhood ependymoma that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</p></div></div><div id="CDR0000062971__180"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062971__180_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062971__180_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062971__180_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062971__182"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062971__182_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062971__182_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000062971__184"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062971__184_55">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062971__184_56">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000062971__281">Follow-up tests for childhood ependymoma include an MRI (magnetic
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resonance imaging) of the brain and spinal cord every 3 months for the first 1 or 2 years after treatment. After 2 years, MRIs may be done every 6 months for the next 3 years. </p></div></div><div id="CDR0000062971__154"><h2 id="_CDR0000062971__154_">Treatment Options for Childhood Ependymoma</h2><div id="CDR0000062971__243"><h3>Newly Diagnosed Childhood Ependymoma</h3><p id="CDR0000062971__224">A child with a newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> has not had treatment for the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. The child may have had treatment to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the tumor.</p><div id="CDR0000062971__257"><h4>Subependymoma</h4><p id="CDR0000062971__244">Treatment of newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> subependymoma (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000559085/" class="def">WHO</a> Grade I) is:</p><ul id="CDR0000062971__247"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">Observation</a> (rarely).</div></li></ul></div><div id="CDR0000062971__258"><h4>Myxopapillary ependymoma</h4><p id="CDR0000062971__245">Treatment of newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> myxopapillary <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000559085/" class="def">WHO</a> Grade I) is:</p><ul id="CDR0000062971__248"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li></ul></div><div id="CDR0000062971__259"><h4>Childhood ependymoma, anaplastic ependymoma, or <i>RELA</i> fusion–positive ependymoma</h4><p id="CDR0000062971__246">Treatment of newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000559085/" class="def">WHO</a> Grade II), <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a> ependymoma (WHO Grade III), or <i>RELA</i> fusion–positive ependymoma (WHO Grade II or Grade III) is:</p><ul id="CDR0000062971__260"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>.</div></li></ul><p id="CDR0000062971__284">After surgery, the plan for further treatment depends on the following:</p><ul id="CDR0000062971__285"><li class="half_rhythm"><div>Whether any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> remain after surgery.</div></li><li class="half_rhythm"><div>Whether the cancer has spread to other parts of the brain or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>.</div></li><li class="half_rhythm"><div>The age of the child.</div></li></ul><p id="CDR0000062971__286">When the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is completely removed and cancer cells have not spread, treatment may include the following:</p><ul id="CDR0000062971__287"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of radiation therapy followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">observation</a> for patients whose tumor is completely removed or who have no sign of cancer after chemotherapy.</div></li></ul><p id="CDR0000062971__288">When part of the tumor remains after surgery, but cancer cells have not spread, treatment may include the following:</p><ul id="CDR0000062971__289"><li class="half_rhythm"><div>A second surgery to remove as much of the remaining tumor as possible.</div></li><li class="half_rhythm"><div>Radiation therapy.</div></li><li class="half_rhythm"><div>Chemotherapy followed by radiation therapy.</div></li><li class="half_rhythm"><div>A clinical trial of chemotherapy given before and after radiation therapy.</div></li></ul><p id="CDR0000062971__290">When cancer cells have spread within the brain and spinal cord, treatment may include the following:</p><ul id="CDR0000062971__291"><li class="half_rhythm"><div>Radiation therapy to the brain and spinal cord.</div></li></ul><p id="CDR0000062971__292">Treatment for children younger than 3 years of age may include the following:</p><ul id="CDR0000062971__293"><li class="half_rhythm"><div>Chemotherapy.</div></li><li class="half_rhythm"><div>Radiation therapy.</div></li><li class="half_rhythm"><div>A clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">3-dimensional (3-D) conformal radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">proton-beam radiation therapy</a>.</div></li></ul><p id="CDR0000062971__TrialSearch_243_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000062971__141"><h3>Recurrent Childhood Ependymoma</h3><p id="CDR0000062971__142">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> may include
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the following:</p><ul id="CDR0000062971__143"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation
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therapy</a>, which may include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">stereotactic radiosurgery</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">intensity-modulated radiation therapy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">proton-beam radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> that checks a sample of the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a> changes. The type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> that will be given to the patient depends on the type of gene change.</div></li></ul><p id="CDR0000062971__TrialSearch_141_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000062971__169"><h2 id="_CDR0000062971__169_">To Learn More About Childhood Brain Tumors</h2><p id="CDR0000062971__170">For more information about childhood brain tumors, see the following:</p><ul id="CDR0000062971__171"><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/wyntk-brain-tumors" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need to Know About™ Brain Tumors</a></div></li><li class="half_rhythm"><div><a href="http://www.pbtc.org/public/gen_info.htm" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Pediatric Brain Tumor Consortium (PBTC)</a></div></li></ul><p id="CDR0000062971__169_44">For more childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other general cancer resources, see the following:</p><ul id="CDR0000062971__169_45"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/childhood-cancers" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Childhood Cancers</a>
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</div></li><li class="half_rhythm"><div><a href="http://www.curesearch.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CureSearch for Children's Cancer</a>
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/aya" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Adolescents and Young Adults with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/guide-for-parents" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Children with Cancer: A Guide for Parents</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer in Children and Adolescents</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062971__AboutThis_1"><h2 id="_CDR0000062971__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062971__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062971__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062971__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062971__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062971__AboutThis_6">This PDQ cancer information summary has current information about the treatment of childhood ependymoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062971__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062971__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000062971__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Pediatric Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062971__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062971__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062971__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062971__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062971__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062971__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062971__AboutThis_21">PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Ependymoma Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/brain/patient/child-ependymoma-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/brain/patient/child-ependymoma-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389185]</p><p id="CDR0000062971__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000062971__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062971__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062971__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062971__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65742.5/?report=reader">PubReader</a></li><li><a href="/books/NBK65742.5/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65742" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65742" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Pediatric Treatment Editorial Board. Childhood Ependymoma Treatment (PDQ®): Patient Version. 2017 Sep 22. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65742.21/">NBK65742.21</a></span> November 5, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65742.20/">NBK65742.20</a></span> June 5, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65742.19/">NBK65742.19</a></span> 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href="/books/NBK65742.9/">NBK65742.9</a></span> July 6, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65742.8/">NBK65742.8</a></span> April 10, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65742.7/">NBK65742.7</a></span> March 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65742.6/">NBK65742.6</a></span> March 16, 2018</li><li><span class="bk_col_itm">NBK65742.5</span> September 22, 2017 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65742.4/">NBK65742.4</a></span> April 7, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65742.3/">NBK65742.3</a></span> August 26, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65742.2/">NBK65742.2</a></span> August 16, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65742.1/">NBK65742.1</a></span> August 27, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062971__73" ref="log$=inpage&link_id=inpage">General Information About Childhood Ependymoma</a></li><li><a href="#CDR0000062971__91" ref="log$=inpage&link_id=inpage">Stages of Childhood Ependymoma</a></li><li><a href="#CDR0000062971__94" ref="log$=inpage&link_id=inpage">Recurrent Childhood Ependymoma</a></li><li><a href="#CDR0000062971__96" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062971__154" ref="log$=inpage&link_id=inpage">Treatment Options for Childhood Ependymoma</a></li><li><a href="#CDR0000062971__169" ref="log$=inpage&link_id=inpage">To Learn More About Childhood Brain Tumors</a></li><li><a href="#CDR0000062971__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65935/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389237" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Craniopharyngioma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Craniopharyngioma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31909939" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Chordoma (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Chordoma (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information 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