Considerations in the Radiation Treatment of Intracranial Ependymoma. Prognosis in 24 Own Cases and Results in Published Series After Different Techniques of Radiation Treatment

The course of 24 patients with intracranial ependymomas after surgical and radiotherapeutic treatment from the years 1954 to 1978 is analysed. The survival rate after 5 and ten years is about 40%. Patients with well differentiated ependymoma, who were irradiated with tumor doses of at least 4000 rad in 4 weeks with inclusion of the whole brain for a part of the dose had a 5-year survival rate well above 50%. In patients with well-differentiated supra or infratentorial ependymomas, prophylactic irradiation of the whole spinal axis is not indicated. Patients with high-grade malignant ependymomas are irradiated by a treatment technique similar to that in patients with medulloblastomas, and additive chemotherapy is administered thereafter. Results of ongoing clinical studies should answer the question, whether this treatment can achieve higher cure rates in patients with high-grade malignant ependymomas.