Adjunctive Therapy

Ependymal tumors are sensitive to radiation. The recommended dose is 4500 rad or more (4500 to 6000 rad over 5 to 6 weeks). As the clinical evidence of spinal seeding of the tumors is small (4 percent for low-grade tumors and 8 percent for high-grade tumors, many authors do not recommend prophylactic radiation of the spinal cord. Local field radiation is the treatment of choice, there is no prevention of spinal metastases by prophylactic radiation. The role of chemotherapy in the treatment of ependymal neoplasms is uncertain: however, it has been reported to delay recurrence of ependymal tumors for up to several years, although the cure rate is not increased.