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1. Surgical resection
The cornerstone of treatment. Maximal safe gross total resection is pursued whenever feasible and is the most important prognostic determinant.
2. Microsurgical and intraoperative adjunct techniques
Neuronavigation, intraoperative MRI, and electrophysiological monitoring enable more precise and safer resection and support surgical quality assurance.
3. Radiotherapy
A standard adjuvant treatment after subtotal resection or for WHO grade II–III disease. Intensity-modulated radiotherapy provides conformal targeting; patients at high risk may require craniospinal irradiation.
4. Chemotherapy
Used in infants, in recurrent disease, or when radiotherapy is not feasible. Regimens such as carboplatin- and etoposide-based protocols have limited efficacy.
5. Tumor treating fields (TTFields)
An emerging physical modality that disrupts cell division; its role in ependymoma remains under investigation.
6. Targeted therapy
Guided by molecular testing; for example, BRAF V600E–mutant tumors may be treated with dabrafenib plus trametinib.
7. Immunotherapy
Immune checkpoint inhibitors, CAR-T therapy, and other approaches remain largely investigational and offer potential options for refractory disease.
8. Optimization of radiotherapy techniques
Refined target delineation (e.g., MD Anderson–based approaches) may reduce the risk of radiation necrosis and lymphopenia.
9. Individualized strategies guided by molecular pathology
DNA methylation profiling and fusion gene testing support risk stratification, treatment selection, and prognostic assessment.
10. Multidisciplinary collaborative model
An MDT team integrates expertise across specialties to develop individualized, longitudinal management plans.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that ependymoma — especially high-grade tumors or lesions in critical locations — can severely compromise neurological function and survival. Early diagnosis and gross total resection are central. An MDT-based approach integrating molecular subtyping with radiotherapy and chemotherapy, together with individualized longitudinal management and lifelong follow-up, is essential to optimize prognosis, preserve organ function, and improve quality of life.
1. Surgical resection
The cornerstone of treatment. Maximal safe gross total resection is pursued whenever feasible and is the most important prognostic determinant.
2. Microsurgical and intraoperative adjunct techniques
Neuronavigation, intraoperative MRI, and electrophysiological monitoring enable more precise and safer resection and support surgical quality assurance.
3. Radiotherapy
A standard adjuvant treatment after subtotal resection or for WHO grade II–III disease. Intensity-modulated radiotherapy provides conformal targeting; patients at high risk may require craniospinal irradiation.
4. Chemotherapy
Used in infants, in recurrent disease, or when radiotherapy is not feasible. Regimens such as carboplatin- and etoposide-based protocols have limited efficacy.
5. Tumor treating fields (TTFields)
An emerging physical modality that disrupts cell division; its role in ependymoma remains under investigation.
6. Targeted therapy
Guided by molecular testing; for example, BRAF V600E–mutant tumors may be treated with dabrafenib plus trametinib.
7. Immunotherapy
Immune checkpoint inhibitors, CAR-T therapy, and other approaches remain largely investigational and offer potential options for refractory disease.
8. Optimization of radiotherapy techniques
Refined target delineation (e.g., MD Anderson–based approaches) may reduce the risk of radiation necrosis and lymphopenia.
9. Individualized strategies guided by molecular pathology
DNA methylation profiling and fusion gene testing support risk stratification, treatment selection, and prognostic assessment.
10. Multidisciplinary collaborative model
An MDT team integrates expertise across specialties to develop individualized, longitudinal management plans.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that ependymoma — especially high-grade tumors or lesions in critical locations — can severely compromise neurological function and survival. Early diagnosis and gross total resection are central. An MDT-based approach integrating molecular subtyping with radiotherapy and chemotherapy, together with individualized longitudinal management and lifelong follow-up, is essential to optimize prognosis, preserve organ function, and improve quality of life.