Gliomas (LGG)

Question 1

different types of gliomas

Answer 1

Astrocytoma- most common
ependymoma- 7% of CNS
oligodendroglioma- 5% of CNS

Question 2

Astrocytoma’s grades

Answer 2

Grade 1 & 2= LGG
Grade 3 & 4 = HGG

Question 3

Grade 1

Answer 3

Benign astrocytoma

Question 4

Grade 2

Answer 4

low grade astrocytoma

Question 5

Grade 3

Answer 5

Anaplastic astrocytoma

Question 6

Grade 4

Answer 6

Glioblastoma (GBM)

Question 7

presentation for Grade 1

Answer 7

Arise in temporal, parietal and frontal lobes
slow growing
may be excised completely
Doesn’t destruct brain they grow in and brain will still function

Question 8

HGG (3 & 4)

Answer 8

-sig damage to neurological function
-degeneration, necrosis
-much larger than anticipated on imaging
-rarely operable (grows rapidly)
-resistant to chemo & RT
-can spread to white matter

Question 9

Oligondendroglioma

Answer 9

-presents often with epilepsy
-common in 40-60yr
-more chemo sensitive than others
-slow growing but can be aggressive
-better overall survival

Question 10

Role of RT for LGG
(advantages)

Answer 10

Delays tumour progression and death.
Improves epilepsy in 50% of px’s.
Neurological deficits freq improves after RT.

Question 11

Role of RT for LGG
(Timing)

Answer 11

survival is unaffected by timing of RT.
NO proven benefit in immediate RT.
RT can be delivered when radiological or symptomatic progression.

Question 12

Role of RT for LGG
(suitability)

Answer 12

Considered if defined high risk of progression.
poor prognosis (40+ >6cm lesions)
Tumour in area directly controlling functions
Seizures unable to be controlled.

Question 13

LGG outcomes

Answer 13

younger age and smaller tumours have better prognosis.
Histological type has effect on prognosis. (Oligodendroglioma do better than astrocytoma)
Median survival 5-7yrs
Early RT delays progression, manages seizures but doesn’t affect overall survival.