{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:03:26Z","timestamp":1788833006612,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T00:00:00Z","timestamp":1634342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T00:00:00Z","timestamp":1634342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2020.02"],"award-info":[{"award-number":["DKS 2020.02"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2017.12"],"award-info":[{"award-number":["DKS 2017.12"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2015.02"],"award-info":[{"award-number":["DKS 2015.02"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2012.03"],"award-info":[{"award-number":["DKS 2012.03"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2008.07"],"award-info":[{"award-number":["DKS 2008.07"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2006.01"],"award-info":[{"award-number":["DKS 2006.01"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Median age at first recurrence was 7.6\u00a0years (IQR: 4.0\u201313.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3\u201320.0) and 36.9\u00a0months (CI 29.7\u201353.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74\u20131.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival\u2009&gt;\u200912\u00a0months after subtotal\/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11060-021-03867-8","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T21:37:31Z","timestamp":1634420251000},"page":"193-202","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies"],"prefix":"10.1007","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4446-8257","authenticated-orcid":false,"given":"Jonas E.","family":"Adolph","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5714-007X","authenticated-orcid":false,"given":"Gudrun","family":"Fleischhack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Gaab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Mikasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Mynarek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Rutkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-1121","authenticated-orcid":false,"given":"Ulrich","family":"Sch\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan M.","family":"Pfister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3562-6121","authenticated-orcid":false,"given":"Kristian W.","family":"Pajtler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Milde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Witt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Bison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Warmuth-Metz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf-Dieter","family":"Kortmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Dietzsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Pietsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Timmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8791-9914","authenticated-orcid":false,"given":"Stephan","family":"Tippelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the German GPOH HIT-Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,16]]},"reference":[{"key":"3867_CR1","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s11060-019-03255-3","volume":"144","author":"L Byer","year":"2019","unstructured":"Byer L, Kline CN, Coleman C, Allen IE, Whitaker E, Mueller S (2019) A systematic review and meta-analysis of outcomes in pediatric, recurrent ependymoma. J Neurooncol 144:445\u2013452. https:\/\/doi.org\/10.1007\/s11060-019-03255-3","journal-title":"J Neurooncol"},{"key":"3867_CR2","doi-asserted-by":"publisher","first-page":"e28426","DOI":"10.1002\/pbc.28426","volume":"67","author":"TA Ritzmann","year":"2020","unstructured":"Ritzmann TA, Rogers HA, Paine SML, Storer LCD, Jacques TS, Chapman RJ, Ellison D, Donson AM, Foreman NK, Grundy RG (2020) A retrospective analysis of recurrent pediatric ependymoma reveals extremely poor survival and ineffectiveness of current treatments across central nervous system locations and molecular subgroups. Pediatr Blood Cancer 67:e28426. https:\/\/doi.org\/10.1002\/pbc.28426","journal-title":"Pediatr Blood Cancer"},{"key":"3867_CR3","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1093\/neuonc\/noaa257","volume":"23","author":"M Massimino","year":"2021","unstructured":"Massimino M, Barretta F, Modena P, Witt H, Minasi S, Pfister SM, Pajtler KW, Antonelli M, Gandola L, Luisa Garre M, Bertin D, Mastronuzzi A, Mascarin M, Quaglietta L, Viscardi E, Sardi I, Ruggiero A, Pollo B, Buccoliero A, Boschetti L, Schiavello E, Chiapparini L, Erbetta A, Morra I, Gessi M, Donofrio V, Patriarca C, Giangaspero F, Johann P, Buttarelli FR (2021) Second series by the Italian association of pediatric hematology and oncology of children and adolescents with intracranial ependymoma: an integrated molecular and clinical characterization with a long-term follow-up. Neuro Oncol 23:848\u2013857. https:\/\/doi.org\/10.1093\/neuonc\/noaa257","journal-title":"Neuro Oncol"},{"key":"3867_CR4","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s40478-019-0820-5","volume":"7","author":"ST Junger","year":"2019","unstructured":"Junger ST, Mynarek M, Wohlers I, Dorner E, Muhlen AZ, Velez-Char N, von Hoff K, Rutkowski S, Warmuth-Metz M, Kortmann RD, Timmermann B, Rahmann S, Klein-Hitpass L, von Bueren AO, Pietsch T (2019) Improved risk-stratification for posterior fossa ependymoma of childhood considering clinical, histological and genetic features\u2014a retrospective analysis of the HIT ependymoma trial cohort. Acta Neuropathol Commun 7:181. https:\/\/doi.org\/10.1186\/s40478-019-0820-5","journal-title":"Acta Neuropathol Commun"},{"key":"3867_CR5","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1007\/s00381-009-1067-4","volume":"26","author":"S Zacharoulis","year":"2010","unstructured":"Zacharoulis S, Ashley S, Moreno L, Gentet JC, Massimino M, Frappaz D (2010) Treatment and outcome of children with relapsed ependymoma: a multi-institutional retrospective analysis. Childs Nerv Syst 26:905\u2013911. https:\/\/doi.org\/10.1007\/s00381-009-1067-4","journal-title":"Childs Nerv Syst"},{"key":"3867_CR6","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1016\/j.ijrobp.2011.10.039","volume":"83","author":"E Bouffet","year":"2012","unstructured":"Bouffet E, Hawkins CE, Ballourah W, Taylor MD, Bartels UK, Schoenhoff N, Tsangaris E, Huang A, Kulkarni A, Mabbot DJ, Laperriere N, Tabori U (2012) Survival benefit for pediatric patients with recurrent ependymoma treated with reirradiation. Int J Radiat Oncol Biol Phys 83:1541\u20131548. https:\/\/doi.org\/10.1016\/j.ijrobp.2011.10.039","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"3867_CR7","doi-asserted-by":"publisher","first-page":"e28930","DOI":"10.1002\/pbc.28930","volume":"68","author":"JW Tsai","year":"2021","unstructured":"Tsai JW, Manoharan N, Alexandrescu S, Zimmerman MA, Scully J, Chordas C, Clymer J, Wright KD, Filbin M, Ullrich NJ, Marcus KJ, Haas-Kogan D, Chi SN, Bandopadhayay P, Yeo KK (2021) Outcomes after first relapse of childhood intracranial ependymoma. Pediatr Blood Cancer 68:e28930. https:\/\/doi.org\/10.1002\/pbc.28930","journal-title":"Pediatr Blood Cancer"},{"key":"3867_CR8","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1093\/neuonc\/noaa276","volume":"23","author":"JE Adolph","year":"2021","unstructured":"Adolph JE, Fleischhack G, Mikasch R, Zeller J, Warmuth-Metz M, Bison B, Mynarek M, Rutkowski S, Schuller U, von Hoff K, Obrecht D, Pietsch T, Pfister SM, Pajtler KW, Witt O, Witt H, Kortmann RD, Timmermann B, Krauss J, Fruhwald MC, Faldum A, Kwiecien R, Bode U, Tippelt S (2021) Local and systemic therapy of recurrent ependymoma in children and adolescents: short- and long-term results of the E-HIT-REZ 2005 study. Neuro Oncol 23:1012\u20131023. https:\/\/doi.org\/10.1093\/neuonc\/noaa276","journal-title":"Neuro Oncol"},{"key":"3867_CR9","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1159\/000028669","volume":"28","author":"J Siffert","year":"1998","unstructured":"Siffert J, Allen JC (1998) Chemotherapy in recurrent ependymoma. Pediatr Neurosurg 28:314\u2013319. https:\/\/doi.org\/10.1159\/000028669","journal-title":"Pediatr Neurosurg"},{"key":"3867_CR10","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1007\/s00381-009-0883-x","volume":"25","author":"E Bouffet","year":"2009","unstructured":"Bouffet E, Capra M, Bartels U (2009) Salvage chemotherapy for metastatic and recurrent ependymoma of childhood. Childs Nerv Syst 25:1293\u20131301. https:\/\/doi.org\/10.1007\/s00381-009-0883-x","journal-title":"Childs Nerv Syst"},{"key":"3867_CR11","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1016\/j.ccell.2015.04.002","volume":"27","author":"KW Pajtler","year":"2015","unstructured":"Pajtler KW, Witt H, Sill M, Jones DT, Hovestadt V, Kratochwil F, Wani K, Tatevossian R, Punchihewa C, Johann P, Reimand J, Warnatz HJ, Ryzhova M, Mack S, Ramaswamy V, Capper D, Schweizer L, Sieber L, Wittmann A, Huang Z, van Sluis P, Volckmann R, Koster J, Versteeg R, Fults D, Toledano H, Avigad S, Hoffman LM, Donson AM, Foreman N, Hewer E, Zitterbart K, Gilbert M, Armstrong TS, Gupta N, Allen JC, Karajannis MA, Zagzag D, Hasselblatt M, Kulozik AE, Witt O, Collins VP, von Hoff K, Rutkowski S, Pietsch T, Bader G, Yaspo ML, von Deimling A, Lichter P, Taylor MD, Gilbertson R, Ellison DW, Aldape K, Korshunov A, Kool M, Pfister SM (2015) Molecular classification of ependymal tumors across all CNS compartments, histopathological grades, and age groups. Cancer Cell 27:728\u2013743. https:\/\/doi.org\/10.1016\/j.ccell.2015.04.002","journal-title":"Cancer Cell"},{"key":"3867_CR12","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1038\/nature25169","volume":"553","author":"SC Mack","year":"2018","unstructured":"Mack SC, Pajtler KW, Chavez L, Okonechnikov K, Bertrand KC, Wang X, Erkek S, Federation A, Song A, Lee C, Wang X, McDonald L, Morrow JJ, Saiakhova A, Sin-Chan P, Wu Q, Michaelraj KA, Miller TE, Hubert CG, Ryzhova M, Garzia L, Donovan L, Dombrowski S, Factor DC, Luu B, Valentim CLL, Gimple RC, Morton A, Kim L, Prager BC, Lee JJY, Wu X, Zuccaro J, Thompson Y, Holgado BL, Reimand J, Ke SQ, Tropper A, Lai S, Vijayarajah S, Doan S, Mahadev V, Minan AF, Grobner SN, Lienhard M, Zapatka M, Huang Z, Aldape KD, Carcaboso AM, Houghton PJ, Keir ST, Milde T, Witt H, Li Y, Li CJ, Bian XW, Jones DTW, Scott I, Singh SK, Huang A, Dirks PB, Bouffet E, Bradner JE, Ramaswamy V, Jabado N, Rutka JT, Northcott PA, Lupien M, Lichter P, Korshunov A, Scacheri PC, Pfister SM, Kool M, Taylor MD, Rich JN (2018) Therapeutic targeting of ependymoma as informed by oncogenic enhancer profiling. Nature 553:101\u2013105. https:\/\/doi.org\/10.1038\/nature25169","journal-title":"Nature"},{"key":"3867_CR13","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-20-1066","author":"A Arabzade","year":"2021","unstructured":"Arabzade A, Zhao Y, Varadharajan S, Chen HC, Jessa S, Rivas B, Stuckert AJ, Solis M, Kardian A, Tlais D, Golbourn BJ, Stanton AJ, Chan YS, Olson C, Karlin KL, Kong K, Kupp R, Hu B, Injac SG, Ngo M, Wang PR, De Leon LA, Sahm F, Kawauchi D, Pfister SM, Lin CY, Hodges HC, Singh I, Westbrook TF, Chintagumpala MM, Blaney SM, Parsons DW, Pajtler KW, Agnihotri S, Gilbertson RJ, Yi J, Jabado N, Kleinman CL, Bertrand KC, Deneen B, Mack SC (2021) ZFTA-RELA dictates oncogenic transcriptional programs to drive aggressive supratentorial ependymoma. Cancer Discov. https:\/\/doi.org\/10.1158\/2159-8290.CD-20-1066","journal-title":"Cancer Discov"},{"key":"3867_CR14","doi-asserted-by":"publisher","first-page":"7822","DOI":"10.18632\/oncotarget.23288","volume":"9","author":"SD Ferguson","year":"2018","unstructured":"Ferguson SD, Zhou S, Xiu J, Hashimoto Y, Sanai N, Kim L, Kesari S, de Groot J, Spetzler D, Heimberger AB (2018) Ependymomas overexpress chemoresistance and DNA repair-related proteins. Oncotarget 9:7822\u20137831. https:\/\/doi.org\/10.18632\/oncotarget.23288","journal-title":"Oncotarget"},{"key":"3867_CR15","doi-asserted-by":"publisher","first-page":"10290","DOI":"10.1038\/s41598-019-46700-z","volume":"9","author":"DH Sabnis","year":"2019","unstructured":"Sabnis DH, Storer LCD, Liu JF, Jackson HK, Kilday JP, Grundy RG, Kerr ID, Coyle B (2019) A role for ABCB1 in prognosis, invasion and drug resistance in ependymoma. Sci Rep 9:10290. https:\/\/doi.org\/10.1038\/s41598-019-46700-z","journal-title":"Sci Rep"},{"key":"3867_CR16","unstructured":"R Core Team (2020) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https:\/\/www.R-project.org\/"},{"key":"3867_CR17","unstructured":"RStudio Team (2020) RStudio: Integrated Development for R. RStudio, PBC, Boston, MA. http:\/\/www.rstudio.com\/"},{"key":"3867_CR18","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1227\/00006123-199510000-00008","volume":"37","author":"IF Pollack","year":"1995","unstructured":"Pollack IF, Gerszten PC, Martinez AJ, Lo KH, Shultz B, Albright AL, Janosky J, Deutsch M (1995) Intracranial ependymomas of childhood: long-term outcome and prognostic factors. Neurosurgery 37:655\u2013666. https:\/\/doi.org\/10.1227\/00006123-199510000-00008 (discussion 666\u2013657)","journal-title":"Neurosurgery"},{"key":"3867_CR19","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.1016\/j.ejca.2009.03.018","volume":"45","author":"B Messahel","year":"2009","unstructured":"Messahel B, Ashley S, Saran F, Ellison D, Ironside J, Phipps K, Cox T, Chong WK, Robinson K, Picton S, Pinkerton CR, Mallucci C, Macarthur D, Jaspan T, Michalski A, Grundy RG, Children\u2019s Cancer Leukaemia Group Brain Tumour Cells (2009) Relapsed intracranial ependymoma in children in the UK: patterns of relapse, survival and therapeutic outcome. Eur J Cancer 45:1815\u20131823. https:\/\/doi.org\/10.1016\/j.ejca.2009.03.018","journal-title":"Eur J Cancer"},{"key":"3867_CR20","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1007\/s11060-020-03434-7","volume":"147","author":"T Gupta","year":"2020","unstructured":"Gupta T, Maitre M, Gupta P, Krishnatry R, Chatterjee A, Moiyadi A, Shetty P, Singh V, Chinnaswamy G, Epari S, Sahay A, Patil V, GodaSastri J (2020) Extent of re-excision, sequence\/timing of salvage re-irradiation, and disease-free interval impact upon clinical outcomes in recurrent\/progressive ependymoma. J Neurooncol 147:405\u2013415. https:\/\/doi.org\/10.1007\/s11060-020-03434-7","journal-title":"J Neurooncol"},{"key":"3867_CR21","doi-asserted-by":"publisher","first-page":"E173","DOI":"10.1002\/ijc.29138","volume":"136","author":"L Nonnenmacher","year":"2015","unstructured":"Nonnenmacher L, Westhoff MA, Fulda S, Karpel-Massler G, Halatsch ME, Engelke J, Simmet T, Corbacioglu S, Debatin KM (2015) RIST: a potent new combination therapy for glioblastoma. Int J Cancer 136:E173-187. https:\/\/doi.org\/10.1002\/ijc.29138","journal-title":"Int J Cancer"},{"key":"3867_CR22","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1080\/15548627.2020.1741318","volume":"17","author":"FRP Dewi","year":"2021","unstructured":"Dewi FRP, Jiapaer S, Kobayashi A, Hazawa M, Ikliptikawati DK, Hartono SH, Nakada M, Wong RW (2021) Nucleoporin TPR (translocated promoter region, nuclear basket protein) upregulation alters MTOR-HSF1 trails and suppresses autophagy induction in ependymoma. Autophagy 17:1001\u20131012. https:\/\/doi.org\/10.1080\/15548627.2020.1741318","journal-title":"Autophagy"},{"key":"3867_CR23","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s12967-021-02834-1","volume":"19","author":"G Wang","year":"2021","unstructured":"Wang G, Jia Y, Ye Y, Kang E, Chen H, Wang J, He X (2021) Identification of key methylation differentially expressed genes in posterior fossa ependymoma based on epigenomic and transcriptome analysis. J Transl Med 19:174. https:\/\/doi.org\/10.1186\/s12967-021-02834-1","journal-title":"J Transl Med"},{"key":"3867_CR24","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1007\/s11060-010-0455-7","volume":"103","author":"DC Bowers","year":"2011","unstructured":"Bowers DC, Kucejova B, Margraf L, Gargan L, Brugarolas J (2011) mTORC1 activation in childhood ependymoma and response to sirolimus. J Neurooncol 103:797\u2013801. https:\/\/doi.org\/10.1007\/s11060-010-0455-7","journal-title":"J Neurooncol"},{"key":"3867_CR25","first-page":"1939","volume":"34","author":"SA Piha-Paul","year":"2014","unstructured":"Piha-Paul SA, Shin SJ, Vats T, Guha-Thakurta N, Aaron J, Rytting M, Kleinerman E, Kurzrock R (2014) Pediatric patients with refractory central nervous system tumors: experiences of a clinical trial combining bevacizumab and temsirolimus. Anticancer Res 34:1939\u20131945","journal-title":"Anticancer Res"},{"key":"3867_CR26","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26409","author":"OJ Becher","year":"2017","unstructured":"Becher OJ, Gilheeney SW, Khakoo Y, Lyden DC, Haque S, De Braganca KC, Kolesar JM, Huse JT, Modak S, Wexler LH, Kramer K, Spasojevic I, Dunkel IJ (2017) A phase I study of perifosine with temsirolimus for recurrent pediatric solid tumors. Pediatr Blood Cancer. https:\/\/doi.org\/10.1002\/pbc.26409","journal-title":"Pediatr Blood Cancer"},{"key":"3867_CR27","doi-asserted-by":"publisher","first-page":"e28134","DOI":"10.1002\/pbc.28134","volume":"67","author":"M Qayed","year":"2020","unstructured":"Qayed M, Cash T, Tighiouart M, MacDonald TJ, Goldsmith KC, Tanos R, Kean L, Watkins B, Suessmuth Y, Wetmore C, Katzenstein HM (2020) A phase I study of sirolimus in combination with metronomic therapy (CHOAnome) in children with recurrent or refractory solid and brain tumors. Pediatr Blood Cancer 67:e28134. https:\/\/doi.org\/10.1002\/pbc.28134","journal-title":"Pediatr Blood Cancer"},{"key":"3867_CR28","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1093\/neuonc\/now016","volume":"18","author":"J Wu","year":"2016","unstructured":"Wu J, Armstrong TS, Gilbert MR (2016) Biology and management of ependymomas. Neuro Oncol 18:902\u2013913. https:\/\/doi.org\/10.1093\/neuonc\/now016","journal-title":"Neuro Oncol"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-021-03867-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-021-03867-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-021-03867-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T08:09:08Z","timestamp":1636618148000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11060-021-03867-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,16]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["3867"],"URL":"https:\/\/doi.org\/10.1007\/s11060-021-03867-8","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,16]]},"assertion":[{"value":"19 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures in these studies involving human participants were done in accordance with the ethical standards of the institutional and national committees. All trials were conducted in accordance with the 1964 Helsinki Declaration and its later amendments or with comparable ethical standards. The institutional review boards or ethics committees of all participating centers reviewed and approved all protocols. All parents\/guardians and patients, when appropriate, gave their written informed consent for data collection and analysis.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent was obtained from all individual participants (patients and\/or their guardians) in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All participants (patients and\/or their guardians) of the included studies gave their informed consent to publish the data obtained in an anonymized publication.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}