Document Detail


Management strategies for recurrent ependymoma in the paediatric population.
MedLine Citation:
PMID:  19484246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The management of recurrent ependymoma within the paediatric population remains a therapeutic challenge. The options available are varied and patients may have already received prior radio- or chemotherapy. As yet, no consensus exists regarding their optimal treatment. We review the literature and present our contemporary management strategies for this interesting group of patients.
RESULTS AND DISCUSSION: Survival following recurrence is poor and those prognostic factors that predispose to recurrence include extent of surgical resection and the timing of administration of adjuvant therapy. The extent of resection at re-operation can confer a survival advantage, without a necessary increase in morbidity. Strategies aimed at improving surgical resection at first diagnosis include improving and centralising post-surgical radiological review, defining what are true residuals, and centralising surgical review of incompletely resected tumours. Re-irradiation can improve survival, and with the use of conformal radiation fields need not necessarily lead to neuropsychological damage. Cisplatin and etoposide remain the most effective chemotherapeutic agents to date and with an increase in the understanding of tumour biology this may improve further. Because of the complex nature of this group of patients, decisions regarding their management require the involvement of a paediatric neurosurgeon, paediatric neuro-oncologist and paediatric radiation oncologist.
Authors:
M Sangra; N Thorp; P May; B Pizer; C Mallucci
Publication Detail:
Type:  Journal Article; Review     Date:  2009-05-30
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  25     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-12-07     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1283-91     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Liverpool, L12 2AP, UK. rsangra@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Brain Neoplasms / diagnosis,  mortality,  therapy
Child
Ependymoma / diagnosis,  mortality,  therapy*
Humans
Neoplasm Recurrence, Local / diagnosis,  mortality,  therapy*
Prognosis
Spinal Neoplasms / diagnosis,  mortality,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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