Initial Management at Presentation
- Surgery: Treatment of infratentorial ependymomas nearly always begins with surgery. Total resection, if achievable, is far superior to incomplete resection, since other treatments are rarely stabilizing and never curative.
- Radiotherapy may prolong event-free survival: Radiotherapy after radical tumor resection lengthens event-free survival time in patients with infratentorial ependymomas of the posterior fossa.
- Chemotherapy used with infants: Chemotherapy can delay progression of infratentorial ependymomas and is used with infants who are too young for radiation.
- Office visits: Initially, frequent office visits are used to monitor for signs of developing hydrocephalus. After frequent initial visits postoperatively, subsequent visits are planned to coincide with scheduled MRIs.
- Postoperative imaging: A brain MRI with and without contrast is typically performed during the first 3 days after surgery and then 3, 6, 9, and 12 months after surgery. Subsequent scanning can be done every 6 months for the next 2 years and then yearly thereafter if there has been no recurrence.
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