Clinical aspects and prognosis of ependymoma in infants and children - A single institution experience

Thirty-two patients (22 boys and 10 girls) with a histologically confirmed diagnosis of ependymoma were treated between 1972 and 1999. A total macrosc opic resection was achieved in 16 of these patients, whereas 15 resections were classified by the surgeon as subtotal. In 1 patient a ventriculostomy was created as part of a palliative strategy. All children over 3 years old were treated with postoperative radiotherapy. Chemotherapy consisted of pr ocarbazine, ifosfamide, etoposide, methotrexate, cisplatin and cytosine ara binoside. There was 1 peri operative death. Twenty children developed a rel apse of disease within 2 months to 13 years and 1 month after the initial t herapy. A maximal number of five recurrences were seen in 1 patient. The va lue of adjuvant chemotherapy on the prognosis of children with ependymoma s eems to be limited. With regard to the poor outcome, the advisability of fu rther treatment after multiple recurrences is debatable.