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Clinical Radiation Oncology II > Gliomas > Flashcards

Gliomas Flashcards

1
Q

What are the two main subdivisions of the nervous system?

A
  1. Central nervous system (CNS)
  2. Peripheral nervous system (PNS)
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2
Q

What does the central nervous system (CNS) consist of?

A

Brain and spinal cord

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3
Q

When does the CNS in children reach morphologic maturation?

A

During the first 2 years of life

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4
Q

What are the four major divisions of the brain?

CCBD

A
  • Cerebrum
  • Cerebellum
  • Brainstem
  • Diencephalon
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5
Q

What is the function of the occipital lobe?

A

Vision and recognition of what has been seen

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6
Q

What are the two main parts of the brainstem?

A
  1. Pons
  2. Medulla
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7
Q

What separates the cerebellum from the inferior portion of the occipital lobe?

A

Tentorium

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8
Q

What is the primary function of the parietal lobe?

A

Storage of memories, touch, thermal sensations, and Wernicke’s speech

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9
Q

What is the role of the frontal lobe?

Front Motor

A

Motor functions and Broca’s speech area

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10
Q

What is a glioma tumour?

A

A tumour that starts in the brain or spine arising from GLIAL cells

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11
Q

What are the main types of gliomas?

AEOM

A
  • Astrocytomas (Astrocytes)
  • Ependymomas (Ependymal cells)
  • Oligodendrogliomas (Oligodendrocytes)
  • Mixed Gliomas (mix of glial cells)
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12
Q

How are gliomas normally named?

A

According to the specific type of cell they most closely resemble

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13
Q

What classification system is found to be inappropriate for brain tumors?

A

Tumour Node Metastasis (TNM) classification system

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14
Q

What is used more often to stage gliomas?

A

Tumour histology

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15
Q

In the WHO Grading System, Grade I is…

PA

A

Pilocytic Astrocytoma

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16
Q

In the WHO Grading System, Grade II is…

A

Low-grade astrocytoma

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17
Q

In the WHO Grading System, Grade III is…

A

Anaplastic Astrocytoma

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18
Q

In the WHO Grading System, Grade IV is…

G4

A

Glioblastoma

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19
Q

Malignant (High Grade) Gliomas represent about ___ of pediatric CNS tumours.

A

10%

20
Q

What is the peak incidence age for brain tumors in children?

A

9 years of age

21
Q

What are common symptoms of low-grade gliomas?

A
  • Headaches
  • Degenerating coordination
  • Visual impairment
  • Poor performance at school
  • Auditory problems
  • Seizures
22
Q

True of False. Low Grade Gliomas present with symptoms that are dependent on the area of the brain affected

A

True

23
Q

What are common symptoms of high-grade gliomas?

IHHVCG

A
  • Increased intracranial pressure
  • Headache
  • Hydrocephalus
  • Vomiting
  • Cerebral dysfunction
  • Gait disturbances
24
Q

What is the main means of detection/diagnosis of Gliomas?

A

MRI

25
Q

True or False. Intracranial primary tumours have lymphatic spread.

A

False

26
Q

What class of tumours have a high risk of CSF spread?

A

Medulloblastoma

27
Q

What is the main prognostic factor for Gliomas?

G-G

A

Tumour grade

28
Q

What is a common treatment approach for low-grade gliomas?

A

Surgery, followed by monitoring or chemotherapy

29
Q

What is the typical radiation therapy dose for children with low-grade gliomas?

A

5000-5400 cGy in 180 cGy fractions

30
Q

What is Dexamethasone used for in high-grade glioma management?

A

A steroid to reduce edema (swelling) and associated symptoms

31
Q

List the side effects of Dexamethasone.

A
  1. Sleep disturbances
  2. Facial swelling
  3. Weight gain
  4. Increased appetite
  5. Upset stomach
32
Q

What is Temozolomide known for?

BBB

A

It is a radiosensitizer that can pass through the blood-brain barrier

33
Q

What are the common side effects of Dexamethasone?

A
  • Sleep disturbances
  • Facial swelling
  • Weight gain
  • Increased appetite
  • Upset stomach
34
Q

What percentage of pediatric CNS tumors are malignant (high grade) gliomas?

A

About 10%

35
Q

For High-Grade Gliomas, RT and Chemo are standard treatment post-op. True or False

A

True

36
Q

What are brain stem gliomas?

A

Tumours of the midbrain, pons, and medulla oblongata

37
Q

What is a common cranial nerve abnormality associated with brain stem gliomas?

A

Cranial nerves VI and VII

38
Q

What is the classification of low-grade astrocytoma?

A

Grade II, well encapsulated

39
Q

What is the main concern when treating high-grade gliomas?

A

Local recurrence of the tumour

40
Q

What is the typical age range for the occurrence of brain stem gliomas?

A

Ages 3 to 9

41
Q

What do we use to fix the issue of facial swelling during RT treatment?

A

At least two spacers on the facial thermoplast mask

42
Q

What is the GTV for RT treatment for High-Grade Gliomas?

A

Tumour bed + abnormalities (MRI)

43
Q

What is the CTV for RT treatment for High-Grade Tumours?

A

GTV + 3cm margin

44
Q

What is the boost dose/fractionation to the CTV in a High-Grade Glioma?

A

6000cGy/30fractions

45
Q

Brain Stem Gliomas arise in the… (3)

PMM

A
  1. Pons
  2. Midbrain
  3. Medulla oblongata
46
Q

50-70% of brain stem tumours arise in which part of the brain?

A

Pons

47
Q

List the treatment side effects of RT for gliomas

A
  1. Hair loss
  2. Increased intracranial pressure
  3. Headache
  4. Nausea and vomiting
  5. Erythema
  6. Gait disturbances

Clinical Radiation Oncology II (10 decks)

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