A cure has not yet been identified for ependymoma. Surgical resection, radiation therapy, and chemotherapy are the primary treatment options. The location, size, and subtype of ependymomas determine which combination of treatments is best.
If surgery is possible, aggressive resection can change the course of this disease for patients. In general, a combination of surgery, chemotherapy, and radiation are often required. Patients can do well from an oligodendrogliomas. If the spine is involved, additional spinal radiation may be beneficial.
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Treatment also includes managing symptoms caused by the ependymoma.
People who experience seizures are treated with an antiseizure drug, such as levetiracetam. Tumor-induced seizures can be challenging to treat, and surgical resection may be able to reduce seizure activity.
Glucocorticoids (steroids) can improve headaches and neurologic deficits caused by cerebral edema. Dexamethasone is frequently prescribed for this purpose but is associated with significant side effects and may shorten survival. Glucocorticoids are used at the lowest effective dose and, ideally, only until other treatments are planned.
Treatment options for ependymoma have expanded in recent years. Some recent treatment advances include:
- Tumor treating electrical fields (Optune): A device worn on the scalp delivers alternating electrical fields to prevent the growth and division of cancer cells.
- Convention-enhanced delivery – Chemotherapy is slowly and continuously delivered to the tumor via a pump.
- Nanoparticle therapy – Special particles allow chemotherapy drugs to cross the blood-brain barrier and improve access to the tumor.
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Ongoing research is needed to improve our understanding of brain tumors and develop more effective therapies. At Stanford, we are exploring new approaches to treating ependymoma, which may offer hope for patients in the future. Some treatments currently being studied are:
- Immunotherapies. Immunotherapy is a type of treatment that uses the patient's immune system to fight cancer. Some experimental immunotherapies for brain tumors include checkpoint inhibitors, CAR T-cell therapy, and vaccines.
- Molecular targeted therapies. Targeted therapy is a type of treatment that targets specific molecules or pathways involved in cancer growth and survival. Some experimental targeted therapies for brain tumors include drugs that target mutations in the IDH1 and IDH2 genes.
Patients may participate in clinical trials to access new treatments under investigation. Please check with your physician to see if you are eligible for a clinical trial.
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