Treatments for grade I and II ependymal tumors usually involve surgery to remove as much of the tumor as possible, which may or may not be followed up with radiation therapy. In some cases, these tumors can be completely removed surgically, and patients whose doctors removed the entire visible tumor have a better chance of long-term survival. Radiation is used to kill any tumor cells that were not removed during surgery (or just to make sure there were no surviving cancer cells). For grade III tumors, surgery and radiation may be used; chemotherapy is also an option for tumors that have grown back after radiation or to delay to use of radiation in infants and young children.
In children, surgery to remove ependymomas can be difficult, as these tumors often extend into the brain stem or out to the side of the brain stem, so radiation therapy is often recommended, especially for older children and adults following surgery. If the tumor is localized, the radiation is most often given to just that part of the brain. If it has spread, however, a boost (an extra amount of radiation) may be given to the area of the brain where the tumor originated.