Use of chemotherapy to treat children with intracranial ependymoma avoids or delays the need for use of radiotherapy which can potentially cause serious damage to the child's nervous system, without compromising chances of survival.
The findings are reported in an Article published Online this week and in the The Lancet Oncology special edition on paediatric oncology.
Intracranial ependymomas are tumours which mostly develop around the lining of the cerebral ventricles. Over half of childhood intracranial ependymomas occur in the children under five-years, and effective treatments are limited. Further, the success of any treatment strategy in this age group has to be measured not only in terms of event-free or overall survival, but also by the potential for serious and/or irreversible damage to the brain. Radiotherapy causes multiple problems in many long-term survivors, including a reduction in intelligence quotient (IQ) and other cognitive defects such as short-term memory loss.
Professor Richard Grundy, Children’s Brain Tumour Research Centre, The Queen’s Medical Centre and University of Nottingham, Nottingham, UK and colleagues did a study of 89 children with ependymoma in the period 1992-2003. Of these, nine had secondary cancers at pre-operative imaging, while in the other 80, the disease had not spread. All had as much of their tumours surgically removed as possible, then received alternating blocks of myelosuppressive* and non-myelosuppressive* chemotherapy for an intended duration of one year. Radiotherapy was withheld unless their disease progressed.