Ependymomas

Question 1

Ependymomas - definition

Answer 1

-60% of intracranial tumours are infratentorial
-spread common to CSF- esp in HG or post fossa.
-Peak incidence age 5 & 35

Question 2

Ependymomas
Grades

Answer 2

1. Subependymoma, Myxopapillary ependymoma (cauda equina)
2. cellular
   papillary
   clear cell
   tanycytic
3. anaplastic ependymoma

Question 3

Ependymoma treatment
Grade 1

Answer 3

Subependymoma alone usually curative.
RT maybe be required if evidence of local progression.
Myopapillary ependymoma
- total resection not poss as risk of death.
sub-total resection produces local control rates

Question 4

Treatment grade 2

Answer 4

surgery
all were given post-op rt in past
evidence some px have remission w/o RT

Question 5

Treatment grade 3

Answer 5

Anaplastic ependymoma- immediate post-op RT
Not used CSRT now majority relapse locally.

Question 6

Immobilisation

Answer 6

For px with posterior fossa/spinal tumour might be treated in a prone position to spare bilateral temporal lobes

Question 7

Target Vols

Answer 7

PTV- +0.3cm to CTV
CTV- Intracranial: G1/G2= GTV +1.5cm
G3= GTV +2.5cm
GTV- CT MRI FUSION

Question 8

Spinal tumour dose

Answer 8

50.4Gy in 28#

Question 9

Cauda equina dose

Answer 9

54Gy in 30#

Question 10

Intracranial tumours

Answer 10

55-60Gy in 30#