Neuro-oncology

Question 1

Anti-Yo antibodies

Answer 1

(aka Anti-purkinje cell) breast and ovarian cancer | Cause cerebellar degeneration

Question 2

Anti-Hu antibodies

Answer 2

(antineuronal nucleoprotein) Pulmonary oat cell carcinoma and lymphoma | Causes sensory neuropathy

Question 3

Anti-Ri antibodies

Answer 3

Breast cancer | Causes opsoclonus

Question 4

Following cytoreductive surgery, What is the standard radiation dose for High Grade Gliomas?

Answer 4

40Gy Whole-brain and 15-20 Gy tumor bed (60 Gy total to tumor). Given in 1.8-2.0 Gy Fractions

Question 5

What is the recommended fractionated radiotherapy dose for low-grade gliomas?

Answer 5

45-54 Gy (total). In 1.8-2 Gy Fractions.

Question 6

For low-grade gliomas, how many cm of margin do you treat for enhancing and non-enhancing regions of tumor?

Answer 6

2cm- enhancing, 1cm-non-enhancing (if surrounding structures allow)

Question 7

What is the dose for craniospinal radiation for ependymoma? What about adult medulloblastoma and PNET?

Answer 7

36 Gy (to bottom of thecal sac) in 1.8Gy fractions. Primary Site should still receive 59 Gy. The Same dose is used for medulloblastoma and PNET (in adults)

Question 8

Is WBRT required for CNS lymphoma? What is the dose?

Answer 8

No. 36 Gy

Question 9

What is the SRS dose for Grade I meningiomas?

Answer 9

12-14 Gy (one dose)

Question 10

What is the conformal radiation dose for Grade II meningiomas?

Answer 10

45-54Gy

Question 11

How are Grade III meningiomas treated radiosurgically?

Answer 11

Like malignant gliomas: 60Gy in 1.8-2.0 Gy fractions

Question 12

What is the WBRT dose for metastasis?

Answer 12

30 Gy in 10 fractions, 37.5 Gy in 15 fractions, or 20Gy in 5 fractions (all found in NCCN guidelines)

Question 13

What is the SRS dose for mets?

Answer 13

24 Gy

Question 14

What is the dose for mets to the spine?

Answer 14

15-40Gy in 1-15 Fractions