Treatment with surgery and adjuvant radiation therapy prolongs like but is seldom curative. For patients with glioblastomas median survival is approximately 10 months, whereas for those with anaplastic astrocytomas, median survival is approximately 2 to 3 years. These tumors, however, tend to me substantially more resistant to chemotherapy than are lymphomas, medulloblastomas, oligodendrogliomas, or germ-cell tumors. Some believe that anaplastic astrocytomas are more responsive to chemotherapy than are GBMs and recommend adjuvant PCV for young patients with good performance status and intermediate-grade gliomas. Ependymoma Ependymomas may occur at all levels of the neuraxis.
Intracranial tumor are more common in children and usually found in the posterior fossa.
Low-grade and anaplastic ependymomas may both occasionally seed the leptomeninges. Treatment includes surgical removal if possible, spinal evaluation with MRI and CSF cytology, and limited-field radiation for localized tumors at diagnosis or craniospinal irradiation for disseminated disease. The median duration of survival is 5 years for patients with intracranial disease. Poor prognostic indicators include young age, supratentorial location, incomplete resection, anaplastic pathology, and early dissemination. For older children and adults, chemotherapy is not included in the standard initial therapy.