Patients are stratified into different treatment arms based on age, tumour location and the result of the primary tumour resection. The goals differ depending on the stratum:
Stratum 1:
Does maintenance chemotherapy (16 weeks VEC-CDDP) after standard radiotherapy in patients = 12 months and complete tumour resection have a positive effect on tumour control as measured by progression-free survival (PFS)?
Stratum 2:
Does the addition of high-dose MTX to VEC chemotherapy improve tumour control in patients = 12 months with residual tumour after primary surgery?
In patients = 12 months of age who still have an inoperable residual tumour after therapy, can a boost of 8 Gy directly following standard radiotherapy achieve local control of tumour growth, improve survival and maintain the patient's quality of life?
Is boost radiotherapy safe for patients (toxicity)?
Stratum 3:
Does the addition of valproate to chemotherapy alone in children < 12 months have a potential benefit on progression-free survival (PFS)? (The aim of this treatment with valproate is to reduce the risk of chemotherapy resistance in order to maximise the intensity of treatment in very young children).
All strata:
Can accompanying molecular analyses within the BIOMECA study improve the further identification of prognostic markers and show the clinical relevance of these markers?
Can central reference assessment of imaging improve the diagnosis of residual tumour disease and does this result in an improved rate of completely resected tumours compared to historical controls?
Does the mandatory obtaining of a neurosurgical second opinion by the SIOP-Ependymoma II Neurosurgery Panel increase the proportion of patients with complete resection before the start of therapy?
