Abstract

The purpose: The management of intracranial ependymomas represents a real challenge and the perfect treatment modality remains controversed. The goal of this study is to highlight the role of tumour removal and the adjuvant therapy in the survival rate of children presenting with intracranial ependymomas. Patients and methods: This retrospective study of 56 children presenting with non-metastatic intracranial ependymomas treated in the period between 2015 and 2020. The age varies from 3 months to 15 years while the mean age was 8 years. The infra tentorial location was found in 67.8%. Result: The total resection of the tumour was achieved in only 42.8% of cases, whereas the subtotal resection was performed in 35.7%. More than 50% of tumours were grade I and II of the Who classification (grade I: 12 cases, grade II: 18 cases). 44.6% were anaplasique ependymomas (grade III: 25 cases). More than half of our cases had initial adjuvant radiotherapy (55.3%) and 21.4% had chemotherapy. 4 children had both radiotherapy and chemotherapy. Complications that were found in our serie were 6 cases of CSF fistula in the origin of 4 cases of meningitis, 9 cases of neurological deterioration with 2 cases of postoperative seizures and 2 other cases of intra ventricular haemorrhage. The mortality rate after 38 months was 7.1% (4 cases). The Follow-up length was 5 years. Conclusion: The role of surgery and the extent of resection in the intracranial ependymomas in children remains the most important factor in the global management of this type of intracranial tumour. adjuvant radiotherapy helps achieving a survival rate for the anaplastic types and recurrences.

Keywords: Anaplastic ependymomas; Ependymomas; Radiotherapy