Pédiatrique divers

DISEASE CHARACTERISTICS:

• Histologically confirmed intracranial ependymoma meeting the following criteria:

  • Newly diagnosed disease

  • Classic ependymoma (WHO II) or anaplastic ependymoma (WHO III), including the following subtypes:

    • Clear cell
    • Papillary
    • Cellular
    • Combination of the above
• No diagnosis of spinal cord ependymoma, myxopapillary ependymoma, subependymoma, ependymoblastoma, or mixed glioma

• Has undergone surgical resection of the primary tumor

  • More than 1 attempted resection allowed

• No metastatic disease by MRI or cerebrospinal fluid (CSF) cytology

  • CSR cytology from a ventriculostomy or permanent VP shunt that reveals the presence of tumor cells is indicative of metastatic disease

• No evidence of non-contiguous spread beyond the primary site as determined by pre- or post-operative MRI of brain, pre- or post-operative MRI of the spine, and post-operative CSF cytology obtained from the lumbar CSF space

  • Lumbar CSF examination may be waived if deemed to be medically contraindicated

PATIENT CHARACTERISTICS:

• ECOG performance status (PS) 0-2

  • Karnofsky PS for patients > 16 years of age
  • Lansky PS for patients ≤ 16 years of age
• ANC ≥ 1,000/μL
• Platelet count ≥ 100,000/μL (transfusion independent)

• Creatinine clearance or radioisotope GFR ≥ 70 mL/min OR serum creatinine based on age/gender as follows:

  • 0.4 mg/dL (1 month to < 6 months of age)
  • 0.5 mg/dL (6 months to < 1 year of age)
  • 0.6 mg/dL (1 to 2 years of age)
  • 0.8 mg/dL (2 to < 6 years of age)
  • 1.0 mg/dL (6 to 10 years of age)
  • 1.2 mg/dL (10 to 13 years of age)
  • 1.5 mg/dL (male) or 1.4 mg/dL (female) (13 to < 16 years of age)
  • 1.7 mg/dL (male) or 1.4 mg/dL (female) (≥ 16 years of age)
• Total bilirubin ≤ 1.5 times upper limit of normal (ULN) (≤ 3 times ULN for patients with Gilbert syndrome or hemolytic anemia)
• AST or ALT < 3 times ULN

• Adequate cardiac function defined as 1 of the following:

  • Shortening fraction ≥ 27% by ECHO
  • Ejection fraction ≥ 50% by gated radionuclide study.

• Not pregnant or nursing

  • Patients who agree to stop nursing while on this study are allowed
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior treatment for ependymoma other than surgical intervention and corticosteroids