Abstract
The primary aim of this randomized phase III trial was to study whether the addition of
maintenance chemotherapy delivered after surgical resection and focal radiation would be
better than surgery and focal radiation alone. The trial also studied if patients who
received induction chemotherapy and then either achieved a complete response or went on to
have a complete resection would also benefit from maintenance chemotherapy. Children ages
1-21 years with newly diagnosed intracranial ependymoma were included. There were 2 arms that
were not randomized. One arm studied patients with Grade II tumors located in the
supratentorial compartment that were completely resected. One arm studied patients with
residual tumor and those patients all received maintenance chemotherapy after focal
radiation. Chemotherapy drugs, such as vincristine sulfate, carboplatin, cyclophosphamide,
etoposide, and cisplatin, work in different ways to stop the growth of tumor cells, either by
killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving
more than one drug (combination chemotherapy) may kill more tumor cells. Radiation therapy
uses high-energy x-rays to kill tumor cells. Specialized radiation therapy that delivers a
high dose of radiation directly to the tumor may kill more tumor cells and cause less damage
to normal tissue. Giving chemotherapy in combination with radiation therapy may kill more
tumor cells and allow doctors to save the part of the body where the cancer started.
