A Phase III Study of Chemotherapy After Radiation in Young Patients with Newly Diagnosed Ependymoma

Ependymoma is a cancer of the brain, most often diagnosed in children, that is usually treated with surgery to remove the tumor, followed by radiation therapy. However, radiation therapy can cause developmental delays, and doctors are trying to determine which patients need radiation and which may be spared. The goal of the study is to see how treatment for ependymoma in patients between the ages of 1 and 21 can be tailored to deliver the most effectiveness with the least side effects.

In this Children’s Oncology Group study, patients will be randomly assigned to one of three groups, and researchers will compare their outcomes:

1. One group will consist of patients whose tumors have been completely removed and, due to the location of the tumor and type of tumor cells, are less likely to experience a cancer recurrence. These patients will receive no further treatment and will be observed.
2. In the second group, patients’ tumors were completely or almost completely removed and, due to the location of the tumor and type of tumor cells, patients are determined to have more of a risk of cancer recurrence. These patients will receive radiation therapy.
3. In the third group, patients’ tumors were partially removed through surgery and more than 5mm of tumor tissue can still be seen on an imaging scan after surgery. These patients will receive chemotherapy after surgery, followed by a second surgery, radiation therapy, maintenance chemotherapy, or observation, depending on the response to treatment.