朋友家的的孩子 A 7 year old boy was diagnosed with right parietal lobe brain tumor (7x5 cm) in Feb 2015 at 6 year old. He had a surgery in Feb 15 with gross total resection, followed by 33 rounds of focal proton radiation. The pathology report says the tumor is high grade glioma (anaplastic enendymoma) with neuronal differentiation. In May 16 he had a seizure and MRI scan found 2 spots. 2nd surgery left some residue tumors. Our questions for next steps are : 1. Side effects for 2nd radiation(CSI) and how to limit the side effects. 2. Recommendation and experiences in chemo/immuno therapy in brain tumor(kid or adult), especially for ependymoma. The tumor profile showed CDK2A, CDK2B, AKT, BRAF, EGFR, ERBB2 etc as possible targets. 男孩，六岁（15年2月）诊断右顶叶脑瘤（7X5 cm), 手术全切后做了33轮Proton放疗。病理报告诊断是间变性室管膜瘤。今年5月复发两个地方，一个原位一个在原位附近。手术没有实现全切。现在需要了解第二次放疗的选择，全脑脊椎还是gamma刀。免疫疗法的病例和经验，特别是免疫和化疗结合在成人和儿童的例子。分子生物测试结果显示CDK2a,Cdk2b变异，可能靶点包括AKT，BRAF, EGFR, erbb2等。 明天和MSK 的医生讨论治疗方案，下周去nyu和chop. 现在的主要问题是要不要再做手术尝试全切，要不要做放疗，化疗/免疫疗法用什么药。