CNS Flashcards
Glioma Treatment Volumes Low and High Grade
low grade: 1-2cm around GTV
High grade: 2-3cm around GTV
Meningioma Treatment Volumes Benign and malignant
Benign: 1cm
Malignant: 3cm
Primary Spinal cord volume
width of post fields 7-8cm
5cm for children
1-2 vertebral bodies above and below
Motor speech area of the brain
sensory speech area of the brain
what is the circle of willis
Broca
Wernicke
Supplies blood to brain
Meningioma Dose
Unresectable or recurrent benign : 5040-54
Atypucal: 54-60
malignant: 60
Lymphoma dose
2340-3600
Primary Spinal cord dose
Intramedullary, ependymoma and astrocytoma
-5040
high grade: 54
SBRT: 10-16
Glioma Dose
RT used for post op, high grade tumours, residual disease, high risk
EBRT, sterotactic or brachy
45-60
low grade 50-54
high grade 60
Locations of tumours and how they affect patients
Frontal
Short term memory loss, episodes of falling or difficulty walking, personality changes, mood changes, moto skills, hemi-paralysis, seizure, drowsiness’, decrease attention
Locations of tumours and how they affect patients
Temporal
Loss of memory, difficulty with hearing, loss of smell, exhibiting signs of not being able to understand and comprehend directions, proptosis
Locations of tumours and how they affect patients
Parietal
Controls sensations, loss of memory, difficulty with hearing
Locations of tumours and how they affect patients
Occipital, Cerebellum and cerebrum
sudden loss of eye sight in one eye
Balance, movement, balance (ataxia)
Temperature, Unilateral weakness and mental changes
Glioma Pathology
MC are gliomas–>can start in the brain or spine
main type of glioma
- astrocytoma
- ependymoma
- oligodendoglioma
Meningioma pathology
Benign (Grade I) 90%
Fibrous + transitional
Atypical (Grade II) <10%
Anaplastic/malignant (Grade III) <5%
Lymphomas pathology
Most are large diffuse B cells lymphoma
-T cell more aggressive and poorer prognosis
Common to have more than one tumour present
Primary Spinal Tumour
Mostly are benign but are problematic
- Extramedullary
- Intramedullary
Prognostic indicators for:
- Gliomas
- meningioma
- lymphomas
- primary spinal cord
- High grade
- Location of lesion
- AGE!!
- tumour type
Epi/Eti for
- Gliomas
- meningioma
- lymphomas
- primary spinal cord
- increase with age (40-80)
environment + occupational factors - sporadic, more common in women (benign), family history and RT to scalp
- immunocompromised like HIV
- most intramedullary are astrocytomas or ependymoma. TSpine
S&S + MC site for
- Gliomas
- meningioma
- lymphomas
- primary spinal cord
- dependent on location
mc location is in cerebrum (supratentorial)
always grow back - Asymptomatic-location based
-localized headaches & seizures
usually benign - dependent on site-tumours are often deep an cause seizure
MC location is cerebrum (supratentorial) - Pain-localized to involved region
numbness/weakness
In general…
- S&S
- prognostic indicators
- Medications
- Dose rage
- head aches
- Pathology/types of tissues involved
- Dexamethazone/Decadrom: swelling
Temozolomide: Radiosensitizer chemo agent - 45-60Gy (200/fx)
Spine Tx volume
width for post fields 7-8cm (5cm for children)
1-2 vertebrae above and below
cervical lesions 4-6MV
T+L spine 10-23MV
