How would you approach treatment of a patient with recurrent choroid plexus papilloma with intraventricular dissemination?   

History of 4th ventricle choroid plexus papilloma s/p GTR, now with recurrent disease in the 4th ventricle and the left lateral ventricle (7 nodules in the lateral ventricle). 

How would a history of left frontal lobe WHO 2 astrocytoma s/p resection followed by recurrence of left frontal lobe WHO 4 astrocytoma treated with re-excision, chemoRT with concurrent Temodar and EBRT to 60 Gy, followed by adjuvant Temodar alter your management? 

Answer from: Radiation Oncologist at Academic Institution