Three-dimensional conformal radiation therapy for ependymoma.
BACKGROUND
The application of conformal radiation therapy in the treatment of pediatric ependymoma is a success story resulting from advances in radiation therapy planning and delivery. These advances occurred at a time when clinical trial results confirmed that radiotherapy avoidance strategies were unsuccessful.


CONCLUSIONS
Investigators have been keen to confirm the promise of newer radiation therapy methods even for the youngest children. When preliminary results suggested that high-dose focal irradiation could be safely administered through systematic targeting and that cognitive function could be preserved, investigators moved to include conformal therapy in the frontline management of children regardless of age. The results with postoperative conformal radiation therapy were further enhanced when neurosurgeons increased the rate of gross-total resection and recognized that second surgery could be safely accomplished after incomplete initial resection. With more than a decade of experience, the role of conformal radiation therapy in the treatment of childhood ependymoma has been firmly established as investigators consider new trials to increase disease control and improve functional outcomes.
Department of Radiological Sciences, Mail Stop 220, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678, USA. thomas.merchant@stjude.org
Thomas E
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Merchant
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome