Recurrent Cancer Cerebellar astrocytoma that recurs is treated, if possible, with another surgery. If this is not possible, local radiation is used. If it recurs in an area where it can't be removed and has already received maximum radiation, chemotherapy should be considered. Since there is little information available about the role of chemotherapy, Phase I and Phase II clinical studies should be considered.
Infratentorial Ependymoma
These tumors arise from the cells lining the fourth ventricle (a cavity within the brain), as well as those lining a cavity in the center of the spinal cord. They can occur anywhere in the brain or spinal cord, but 60 percent of them start in the part of the brain in the back of the skull, the posterior fossa. The prognosis depends on the grade and size of the tumor and the degree of spread. These tumors may spread via the spinal fluid pathways.
Standard Treatment Surgical excision followed by high-dose radiation to the back part of the brain is the usual treatment. Radiotherapy to the entire brain and spinal cord is controversial, being used most commonly in high-grade tumors.
There is no clear benefit for adjuvant chemotherapy , although consideration should be given to using chemotherapy to delay or modify radiation therapy in very young children.
