Table 3.

Key recommendations for the treatment of recurrent intracranial ependymomas in adults and children

	Class of Evidence	Level of Recommendation
Re-operation and/or re-irradiation should be proposed whenever possible. However, if only incomplete resection was achievable due to functional restrictions at first surgery, the same limitations will be faced at re-operation; hence, in these cases the indication for another incomplete resection should be made cautiously.	III	C
In patients with recurrent ependymomas who are no longer eligible for local treatments, chemotherapy might be warranted, particularly in patients with a good performance status.	III	C
In adults, either platinum compounds or temozolomide (based on a more favorable toxicity profile) should be considered. Options for participation in a clinical trial should be explored.	IV	Good Practice Point
In children, the choice of chemotherapeutic drugs depends on previous exposures. Options for participation in a clinical trial should be explored.	n.a.	Good Practice Point