Observation or Radiation Therapy and/or Chemotherapy and Second Surgery in Treating Children Who Have Undergone Surgery for Ependymoma
Brain Tumor, Central Nervous System Tumor
About this trial
This is an interventional treatment trial for Brain Tumor focused on measuring childhood supratentorial ependymoma, newly diagnosed childhood ependymoma, childhood infratentorial ependymoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed intracranial ependymoma Differentiated ependymoma or anaplastic ependymoma No primary spinal cord ependymoma, myxopapillary ependymoma, subependymoma, ependymoblastoma, or mixed glioma No evidence of noncontiguous spread beyond primary site Initial surgical resection within the past 56 days PATIENT CHARACTERISTICS: Age: 1 to 21 Performance status: No restrictions Life expectancy: At least 2 months Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Other: Able to undergo MRI Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior chemotherapy Endocrine therapy: Prior or concurrent corticosteroids allowed Radiotherapy: No prior radiotherapy Surgery: See Disease Characteristics More than 1 prior surgery allowed Other: No other prior treatment for ependymoma
Sites / Locations
- Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
- Phoenix Children's Hospital
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- Loma Linda University Cancer Institute at Loma Linda University Medical Center
- Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
- Childrens Hospital Los Angeles
- Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
- Children's Hospital Central California
- Children's Hospital & Research Center Oakland
- Children's Hospital of Orange County
- Sutter Cancer Center
- University of California Davis Cancer Center
- Kaiser Permanente Medical Center - Oakland
- Children's Hospital and Health Center - San Diego
- UCSF Comprehensive Cancer Center
- Stanford Comprehensive Cancer Center - Stanford
- Children's Hospital Cancer Center
- Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
- Alfred I. duPont Hospital for Children
- Children's National Medical Center
- Lee Cancer Care of Lee Memorial Health System
- University of Florida Shands Cancer Center
- Nemours Children's Clinic
- Miami Children's Hospital
- Florida Hospital Cancer Institute at Florida Hospital Orlando
- Nemours Children's Clinic - Orlando
- Sacred Heart Cancer Center at Sacred Heart Hospital
- All Children's Hospital
- St. Joseph's Cancer Institute at St. Joseph's Hospital
- Kaplan Cancer Center at St. Mary's Medical Center
- Winship Cancer Institute of Emory University
- MBCCOP - Medical College of Georgia Cancer Center
- Cancer Research Center of Hawaii
- St. Luke's Mountain States Tumor Institute - Boise
- Rush University Medical Center
- Children's Memorial Hospital - Chicago
- University of Chicago Cancer Research Center
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Advocate Christ Medical Center
- Advocate Lutheran General Cancer Care Center
- Saint Jude Midwest Affiliate
- Southern Illinois University School of Medicine
- St. Vincent Indianapolis Hospital
- Blank Children's Hospital
- Markey Cancer Center at University of Kentucky Chandler Medical Center
- Kosair Children's Hospital
- CancerCare of Maine at Eastern Maine Medial Center
- Maine Children's Cancer Program at Barbara Bush Children's Hospital
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Floating Hospital for Children at Tufts - New England Medical Center
- Massachusetts General Hospital
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
- C.S. Mott Children's Hospital at University of Michigan Medical Center
- Barbara Ann Karmanos Cancer Institute
- Hurley Medical Center
- Spectrum Health Hospital - Butterworth Campus
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- CCOP - Kalamazoo
- Breslin Cancer Center at Ingham Regional Medical Center
- Children's Hospitals and Clinics of Minnesota - Minneapolis
- University of Minnesota Cancer Center at University of Minnesota
- Mayo Clinic Cancer Center
- University of Mississippi Cancer Clinic
- Children's Mercy Hospital
- Cardinal Glennon Children's Hospital
- Siteman Cancer Center at Barnes-Jewish Hospital
- Children's Hospital
- Sunrise Hospital and Medical Center
- Hackensack University Medical Center Cancer Center
- Overlook Hospital
- Saint Peter's University Hospital
- Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
- St. Joseph's Hospital and Medical Center
- University of New Mexico Cancer Research and Treatment Center
- Albany Medical Center Hospital
- Albert Einstein Cancer Center at Albert Einstein College of Medicine
- Roswell Park Cancer Institute
- Schneider Children's Hospital
- NYU Cancer Institute at New York University Medical Center
- Memorial Sloan - Kettering Cancer Center
- Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- SUNY Upstate Medical University Hospital
- New York Medical College
- Blumenthal Cancer Center at Carolinas Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Duke Comprehensive Cancer Center
- Wake Forest University Comprehensive Cancer Center
- CCOP - MeritCare Hospital
- Children's Hospital Medical Center of Akron
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Children's Hospital
- Cleveland Clinic Taussig Cancer Center
- Columbus Children's Hospital
- Children's Medical Center - Dayton
- Toledo Hospital
- Medical University of Ohio Cancer Center
- Tod Children's Hospital
- Oklahoma University Cancer Institute
- Legacy Emanuel Hospital and Health Center & Children's Hospital
- Geisinger Medical Center
- Penn State Cancer Institute at Milton S. Hershey Medical Center
- Children's Hospital of Philadelphia
- St. Christopher's Hospital for Children
- Children's Hospital of Pittsburgh
- Rhode Island Hospital Comprehensive Cancer Center
- Hollings Cancer Center at Medical University of South Carolina
- Greenville Hospital System Cancer Center
- Sanford Cancer Center at Sanford USD Medical Center
- T.C. Thompson Children's Hospital
- East Tennessee Children's Hospital
- St. Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- Texas Tech University Health Sciences Center School of Medicine - Amarillo
- Children's Hospital of Austin
- Driscoll Children's Hospital
- Medical City Dallas Hospital
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
- Cook Children's Medical Center - Fort Worth
- Baylor University Medical Center - Houston
- M. D. Anderson Cancer Center at University of Texas
- Covenant Children's Hospital
- Methodist Children's Hospital of South Texas
- CCOP - Scott and White Hospital
- Primary Children's Medical Center
- Fletcher Allen Health Care - University Health Center Campus
- INOVA Fairfax Hospital
- Children's Hospital of The King's Daughters
- Naval Medical Center - Portsmouth
- Virginia Commonwealth University Massey Cancer Center
- Carilion Cancer Center of Western Virginia
- Children's Hospital and Regional Medical Center - Seattle
- Providence Cancer Center at Sacred Heart Medical Center
- West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division
- Edwards Comprehensive Cancer Center at Cabell Huntington Hospital
- St. Vincent Hospital Regional Cancer Center
- University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
- Marshfield Clinic - Marshfield Center
- Midwest Children's Cancer Center
- John Hunter Hospital
- Prince of Wales Private Hospital
- Westmead Institute for Cancer Research at Westmead Hospital
- Royal Children's Hospital
- Women's and Children's Hospital
- Royal Children's Hospital
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- University of Alberta Hospital
- Children's & Women's Hospital of British Columbia
- CancerCare Manitoba
- IWK Health Centre
- McMaster Children's Hospital at Hamilton Health Sciences
- Children's Hospital of Western Ontario
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- Hopital Sainte Justine
- Allan Blair Cancer Centre at Pasqua Hospital
- Saskatoon Cancer Centre at the University of Saskatchewan
- Centre Hospitalier Universitaire de Quebec
- University Medical Center Groningen
- Starship Children's Health
- Swiss Pediatric Oncology Group Bern
- Swiss Pediatric Oncology Group Geneva
- Swiss Pediatric Oncology Group Lausanne
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Experimental
Experimental
GTR1 Differentiated Histology Supratentorial (Group 1)
Radiation (Group 2)
Sub-Total Resection Any Histology or Location (STR) (Group 3)
Patients undergo observation.
Supratentorial Anaplastic Ependymoma (GTR1, GTR2, NTR) and Anaplastic or Differentiated Infratentorial Ependymoma (GTR1, GTR2, NTR) and Supratentorial Differentiated Ependymoma(GTR2, NTR). Patients undergo conformal radiation therapy to the brain once daily 5 days a week for 6-6½ weeks.
Patients receive an initial course of chemotherapy comprising vincristine sulfate IV on days 1 and 8, carboplatin IV over 1 hour on day 1, and cyclophosphamide IV over 1 hour on days 1 and 2. Patients also receive filgrastim (G-CSF) subcutaneously or IV beginning on day 3 and continuing until blood counts recover. Patients then receive a second course of chemotherapy comprising vincristine sulfate IV on days 1 and 8, carboplatin IV over 1 hour on day 1, and oral etoposide on days 1-21. After completion of chemotherapy, patients are evaluated for second therapeutic conventional surgery. Patients who have unresectable disease undergo conformal radiation therapy. Patients who have resectable disease undergo second surgery followed by conformal radiotherapy.