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RO Clinical Boards > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Dose of RT for orbital embryonal rhabdo on ARST0331

A

45 Gy [Group 3]

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2
Q

Dose for group III disease on ARST0331

A

45 Gy orbit

50.4 all other sites

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3
Q

Dose for R1 rhabdo per ARST0331

A

41.4 Gy

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4
Q

Research question on COG ARST0331 rhabdo

A

reduction of cyclophosphamide dose to reduce sterility

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5
Q

When does RT start on ARST0331

A

week 13

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6
Q

What chemo is given on ARST0331

A

VAC - reduced C dose

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7
Q

ACNS0331 medullo trial question

A
  1. CSI dose (for young kids)

2. posterior fossa or involved field boost

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8
Q

ACNS0331 medullo Doses of RT used (age 3-7)

A

Age 3-7: 23.4 vs. 18 Gy CSI –> posterior fossa or IF boost to 54 Gy

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9
Q

ACNS0331 medullo Doses of RT used (age 8+)

A

23.4 CSI randomization to either PF or IF boost to 54 Gy

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10
Q

Chemo used on ACNS0331

A

Concurrent vincristine

then adjuvant vincristine/cisplatin/CCNU alternating with vincristine/cyclophosphamide

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11
Q

ACNS0331 medullo tumor bed boost contour

A

GTV + cavity plus 1.5 cm CTV margin off bone/tentorium

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12
Q

Predictor of anesthesia complications for kids

A

duration of procedure

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13
Q

Peak age for medulloblastoma

A

5-9 years old

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14
Q

How many medulloblastomas disseminated at diagnosis

A

1/3

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15
Q

What imaging is needed for medullo

A

brain and spine MRI

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16
Q

When should CSF cytology be obtained

A

10-14 days after surgery

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17
Q

What other tests should be obtained

A
  1. baseline neurocog eval

2. audiology eval

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18
Q

Chang stage M0

A

No metastasis

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19
Q

Chang stage M1

A

Microscopic tumor in CSF

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20
Q

Chang stage M2

A

Gross nodules intracranially beyond primary

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21
Q

Chang stage M3

A

Gross nodules in spinal subarachnoid space

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22
Q

Chang stage M4

A

mets outside Craniospinal axis

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23
Q

What is most favorable medullo subtype

A

Wnt (90% OS)

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24
Q

Wnt subtype associated with which syndrome

A

APC mutations - Turcot syndrome

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25
Q

SHH subtype prognosis

A

good for infants, intermediate for children

80% OSS

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26
Q

Worst prognosis medullo class

A

Group 3

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27
Q

Group 3 medullo has which mutation

A

Myc amplification

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28
Q

Group 4 prognosis

A

second to worst, above Group 3

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29
Q

What is standard risk medullo

A

M0
GTR or less than 1.5 cm of residual disease
Classic or desmoplastic histology

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30
Q

Treatment for standard risk medullo

A

CSI to 23.4

Posterior fossa or IF boost to 54

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31
Q

Chemo for medullo

A 
weekly vincristine (controversial)
then VCR - vincristine, cisplatin, CCNU
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32
Q

Prognosis for standard risk medullo

A

86% OS

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33
Q

Intermediate risk medullo definition

A

Standard risk plus diffuse anaplasia or large cell variant

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34
Q

Intermediate risk medullo

A

Treat with 36 Gy CSI like high risk

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35
Q

High risk medullo definition

A

M+ disease

STR with >1.5 cm gross residual

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36
Q

Treatment of high risk medullo

A

CSI to 36 Gy
PF/IF boost to 54-55.8 Gy
Concurrent vincristine
adjuvant cisplatin containing chemo

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37
Q

Prognosis of high risk medullo

A

EFS 60-70%

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38
Q

Total adjuvant chemo

A

9 cycles, 55 weeks

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39
Q

Results of ACNS0331 re dose

A

18 Gy inferior to 23.4 Gy

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40
Q

Results of ACNS0331 re field design

A

involved field boost to 54 Gy is ok

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41
Q

ACNS0331 risk of local failure

A

1-5%

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42
Q

Epidemiology of craniopharyngioma

A

Bimodal - infants/children and adults aged 55-65

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43
Q

Location for craniopharyngioma

A

remnant of Rathke’s pouch

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44
Q

Craniopharyngioma CT appearance

A

calcified suprasellar mass with cystic/solid components

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45
Q

Treatment of craniopharyngioma

A

GTR –> observation

Maximal safe resection –> RT (90% control)

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46
Q

CTV for craniopharyngioma

A

GTV + 1 cm

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47
Q

Dose for cranio

A

54 Gy is preferred since doses <54Gy associated with LF

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48
Q

Germ cell tumors are more common in males/females

A

Males

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49
Q

Where is most common intracranial GCT

A

pineal

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50
Q

Epidemiology of intracranial GCT

A

teens/puberty

Higher predominance in Japan/East Asia

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51
Q

Tumor marker profile for pure germinoma

A

Normal bHCG or slightly elevated

Normal AFP

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52
Q

Tumor marker profile for embryonal carcinoma

A

Elevated bHCG

Elevated AFP

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53
Q

Tumor marker profile for yolk sac tumor

A 
Normal bHCG
Elevated AFP (very high)
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54
Q

Tumor marker profile for choriocarcinoma

A

Very elevated bHCG

Normal AFP

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55
Q

Tumor marker profile for teratoma

A

Normal bHCG

Normal AFP

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56
Q

Role of biopsy for GCT

A

do unless markers are positive

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57
Q

Germinoma pathology

A

small round blue cells

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58
Q

Good prognosis GCT

A

pure germinoma, mature teratoma

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59
Q

Cure rate for pure germinomas

A

95%

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60
Q

Staging for GCT

A

M0 - CSF negative

M1 - CSF positive

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61
Q

Treatment for M0 pure germinoma

A

Radiation alone

21-24 Gy whole ventricle RT with boost to 30-36 Gy in 1.5 Gy fractions

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62
Q

Treatment for M1 pure germinoma

A

Two options

  1. RT alone: 24-30 Gy CSI –> IF boost to 45 Gy
  2. ChemoRT: carbo-etop x 2 –> 24 Gy CSI –> boost to 30-36 Gy
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63
Q

NGGCT treatment

A

Chemo first (4-6 cycle of carbo/etop then ifos/etop)
If CR with normal markers –> RT
If PR –> second look surgery

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64
Q

Dose of RT for NGGCT

A

CSI 36 Gy

IF boost to 54 Gy

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65
Q

Syndrome with risk factor of ependymoma

A

NF2

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66
Q

Where does spinal cord end in children

A

L3

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67
Q

Where does thecal sac end in children

A

S2

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68
Q

What is most important prognostic factor for ependymoma

A

extent of resection

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69
Q

Most common location for ependymoma

A

4th ventricle/PF

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70
Q

How do ependymomas spread?

A

along spinal axis

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71
Q

WHO I ependymoma

A

myxopapillary ependymoma or subependymoma

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72
Q

Treatment of WHO grade I

A

surgery alone

RT for STR or recurrence

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73
Q

WHO grade II ependymoma

A

ependymoma

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74
Q

WHO grade III ependymoma

A

anaplastic

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75
Q

WHO grade IV ependymoma

A

ependymoblastoma (now PNET)

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76
Q

Group A ependymomas

A

Most common, posterior fossa, more aggressive

H3K27

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77
Q

Group B ependymoma

A

more favorable, older children

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78
Q

Treatment approach for ependymoma

A

GTR followed by IFRT

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79
Q

RT approach for ependymoma

A

conformal RT with CTV margin of 1 cm

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80
Q

RT dose for ependymoma

A

59.4 in 33

54 if <18 months

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81
Q

Genetic syndrome associated with LGG

A

NF1

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82
Q

What is most common pediatric brain tumor

A

LGG

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83
Q

Most common location of LGG

A

infratentorial

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84
Q

Treatment of pediatric LGG

A

GTR if feasible: 10 year PFS 80-90%

Chemo if young to delay RT

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85
Q

CTV for LGG

A

GTV + 5mm

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86
Q

Recommended dose for HGG

A

54 Gy if GTR

60 Gy if STR

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87
Q

Dose for DIPG

A

54 Gy in 1.8 Gy fractions

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88
Q

What proportion of Rb is heritable

A

25%

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89
Q

Plaque options for Rb lesion

A

6-15 mm in size

<10 mm depth

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90
Q

Dose of plaque

A

40 Gy to apex

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91
Q

EBRT dose for locally advanced

A

45 Gy

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92
Q

Neuroblastoma is most common malignancy in children < X months

A

18

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93
Q

With neuroblastoma older children do better/worse

A

worse

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94
Q

What labs to check for neuroblastoma

A

VMA, HVA, epi, norepi in urine in 90% of cases

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95
Q

MIBG is an analogue of what hormone

A

norepi

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96
Q

MYCN amplification is associated with better/worse survival

A

worse

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97
Q

Stage I neuroblastoma

A

Localized, completely resected

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98
Q

Stage IIA neuroblastoma

A

Localized, incomplete resection, N0

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99
Q

Stage IIB neuroblastoma

A

Localized (R0/R1) + ipsi lymph node

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100
Q

Stage III neuroblastoma

A

Unresectable crossing midline +/- LN

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101
Q

Stage IV neuroblastoma

A

distant mets

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102
Q

Stage IV-S neuroblastoma

A

primary tumor with mets in skin, liver, bone in <1 year old –> good prognosis

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103
Q

Low risk treatment

A

surgery alone

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104
Q

High risk neuroblastoma treatment approach

A 
Induction chemo
Radical surgery
Myeloablative consolidative therapy (x2)
Local radiation
Cis-retinoic acid or targeted therapies
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105
Q

What is the volume used for radiation for neuroblastoma

A

Post induction chemo

Pre surgery

106
Q

Dose to preop primary

A

21.6 (boost to 36 if residual)

107
Q

Dose to mets

A

21.6

108
Q

Dose for 4S with massive hepatomegaly

A

4.5 / 3 fx

109
Q

Dose for cord compression in young child

A

9 / 5

110
Q

How does cis retinoid acid work

A

causes differentiation

111
Q

Syndromes that predispose to Wilms tumor

A

Beckwidth-Wiedemann
WAGR
Denys-Drash

112
Q

What does WAGR stand for

A

Wilms, Aniridia, ambiguous genitalia, MR

113
Q

What is mutation associated with WAGR

A

WT1

114
Q

When should biopsy be done for Wilms

A

Never, unless unresectable or bilateral disease

115
Q

Stage I Wilms

A

limited to kidney
completely excised
intact renal capsule
uninvolved vessels

116
Q

Stage II Wilms

A

Completely resected but tumor extends regionally (capsule, soft tissue, blood vessel outside parenchyma)

117
Q

Stage III Wilms

A 
BSLURPP
Biopsy
STR/+margin
LN (abdominal)
Unresectable
Rupture/spillage
Piecemeal resection
Perionteal implant
118
Q

Stage IV Wilms

A

hematogenous mets

LN mets outside abdominopelvic region

119
Q

Stage V Wilms

A

bilateral renal involvement

120
Q

Approach for high risk Wilms tumor

A
  1. Preop chemo
  2. Surgery
  3. Postop RT
121
Q

Chemo for Wilms

A

Stage I/II: Vincristine + actinomycin-D

Stage III/IV adriamycin 3+ agents

122
Q

Dose for whole lung RT

A

12/6

123
Q

When should whole lung be used

A

lung mets on CXR (not if only visible on CT)

124
Q

Dose for flank RT

A

10.8 in 6 fractions

Boost to 19.6

125
Q

Ideal start date of RT for Wilms

A

9-14 days after surgery

126
Q

Dose for rhabdoid tumor or stage III with diffuse anaplasia

A

19.8

127
Q

Favorable rhabdo sites

A
  1. non-parameningeal HN
  2. orbit
  3. GU non-bladder/prostate
  4. biliary tract
128
Q

Unfavorable rhabdo sites

A
  1. parameningeal
  2. bladder/prostate
  3. extremities
  4. trunk/RP
129
Q

Which subtype associated with FOX01 fusion

A

alveolar

130
Q

FOX01 is what translocation

A

t(2;13)

131
Q

Wilms RT approach for flank

A

Preop tumor bed + 1cm
Do not split vertebral bodies to prevent scoliosis
Cross midline 1 cm beyond vert body to include bilateral PA if tumor is N+

132
Q

Stage 1 rhabdo

A

favorable sites (any size, any N)

133
Q

Stage 2 rhabdo

A

<5 cm unfavorable site, N0

134
Q

Stage 3 rhabdo

A

> 5cm unfavorable site, N+

135
Q

Stage 4 rhabdo

A

mets

136
Q

Group 1 rhabdo

A

completely excised

137
Q

Group 2 rhabdo

A

microscopic margin or LN+

138
Q

Group 3 rhabdo

A

gross residual or unresected

139
Q

Group 4 rhabdo

A

mets

140
Q

Low risk rhabdo

A

stage 1 rhabdo embryonal

stage 2 or 3 embryonal group 1/2

141
Q

High risk rhabdo

A

mets other than age <10 embryonal

142
Q

Approach to treat low risk rhabdo

A

VAC x 12 weeks –> surgery and/or RT –> more chemo

143
Q

Approach to treat high risk rhabdo

A

RT at week 12 or 20, treat mets after completion of chemo

144
Q

When to start RT for low/intermediate risk

A

week 12

145
Q

Rhabdo chemo backbone

A

VAC
Vincristine
Actinomycin
Cyclophosphamide

146
Q

Dose for favorable sites, group I

A

36 Gy

147
Q

Dose for unfavorable, group 2, N0

A

36 Gy

148
Q

Dose for unfavorable, group 2, N+

A

41.4 Gy

149
Q

Dose for Group 3 orbital

A

45 Gy

150
Q

Dose for Group 3, gross disease < 5cm

A

50.4 Gy

151
Q

Dose for Group 3, gross disease > 5cm

A

59.4 Gy

152
Q

Dose for whole lung RT

A

15 Gy in 10

153
Q

Approach for paratesticular rhabdo

A

If >10 –> RPLND

If <10 –> thin slice CT to eval for nodes

154
Q

Peak age for Ewing

A

15

155
Q

Epidemiology

A

more common in whites

M:F 1.5:1

156
Q

Ewing sarcoma usual presents where in long bones

A

diaphysis (central)

157
Q

Osteosarcoma usually presents where in long bones

A

metaphysis

158
Q

Chemo for Ewing

A 
VAC-IE
Vincristine
Adriamycin
Cyclophosphamide
Ifos
Etoposide
159
Q

When is RT given for Ewing

A

12 weeks

160
Q

RT dose for gross disease Ewing

A

55.8

161
Q

RT dose for microscopic Ewing

A

50.4

162
Q

What to treat for Ewing

A

45 Gy to pre-chemo + 2 cm

CD to prechemo bone volume, postchemo soft tissue volume

163
Q

Low risk Hodgkin stages

A

IA

IIA

164
Q

Treatment of low risk Hodgkin

A

ABVE-PC x 4
21 Gy ISRT for PR
No RT for CR

165
Q

Intermediate risk Hodgkin stages

A

IIA (bulk), IIIA, IVA (w or wo bulk)

166
Q

Treatment of intermediate risk Hodgkin

A 
ABVE-PC x 2 
Assessment of Response
ABVE-PC x2
If RER and CR: no RT
If PR: 21 Gy
If SER: escalate to DECA --> 21 Gy
167
Q

Definition of RER

A

60% reduction in CT PPD

168
Q

High risk Hodgkin

A

IIIB or IVB

169
Q

Role of RT for high risk Hodgkin

A

ISRT to initial PR or sites of bulk

170
Q

Risk factor for cardiac complications in 5 year Ewing sarcoma survivors

A

chest RT

NOT anthracycline dose

171
Q

Any alveolar rhabdo histology is considered what risk

A

intermediate

unless mets –> high risk

172
Q

Intermediate risk peds Hodgkin includes what stages

A 
IA with bulk
IIA with bulk
I-IIAE with or without bulk
I-IIB with or without bulk
IIIA with or without bulk
IVA with or without bulk
173
Q

What endpoints were improved in Hodgkin pts with RER

A

EFS

OS

174
Q

Standard Wilm’s fields for postop flank RT

A

Preop tumor bed + 1 cm

175
Q

RT dose for rhabdoid tumor of kidney or stage III with anaplasia

A

19.8 Gy

176
Q

what is 4S neuroblastoma

A

localized primary with only skin, liver or bone marrow involvement in infant < 12 months

177
Q

Rate of secondary malignancies in 35 year followup for Ewing survivors

A

14%

178
Q

OS of osteosarcoma with surgery alone

A

20%

179
Q

OS of osteosarcoma with surgery + chemo

A

70% at 5 years

180
Q

ATRT treatment

A

surgery
if children < 3: 50.4 to primary site alone
if children > 3: add 36 Gy CSI

181
Q

Parinaud symptoms

A

Impaired upward gaze
psuedo Argyll-Robertson pupil
vertical nystagmus

182
Q

psuedo Argyll-Robertson pupil

A

impaired pupil reaction to light but not accomodation

183
Q

When do kids with T-ALL get testicular RT

A

remains positive after chemo

184
Q

Dose of testicular RT

A

24 Gy / 12

185
Q

CNS 1 leukemia

A

CSF negative

186
Q

CNS 2 leukemia

A

WBC count <5 and blasts on cytology

187
Q

CNS 3 leukemia

A

WBC >5 and blasts on cystology or clinical signs of CNS leukemia

188
Q

Ewing translocation

A

t(11;22) EWS-FLI1

189
Q

What stages of favorable histology Wilms require RT

A

stage III and IV

190
Q

Chemo used for Wilms

A

Vincristine + actinomycinD

191
Q

Radiation dose for anaplastic ependymoma

A

59.4 (54 Gy then 5.4 Gy boost)

If younger than 18 months: ok to do 54 only

192
Q

Most common malignant brain tumor of childhood

A

medulloblastoma

193
Q

Peak incidence of medulloblastoma

A

5-9

194
Q

10 year cumulative incidence of second malignancies in medullo patients treated with CSI, PF boost, chemo

A

4%

195
Q

Median age of presentation for neuroblastoma

A

22 months

196
Q

Most common extracranial solid tumor in children

A

neuroblastoma

197
Q

Ewing sarcoma dose for unresectable

A

45 Gy to pre-chemo volume + 2cm

CD to 55.8 Gy to prechemo bone and postchemo soft tissue

198
Q

When does posterior fossa syndrome occur

A

1-2 days after resection of midline PF tumor

199
Q

Symptoms of PF syndrome

A

mutism
difficulty swallowing
emotional lability
ataxia

200
Q

How should treatment change for medullo kids with PF syndrome?

A

It shouldn’t

201
Q

5 year OS for average risk medullo per ACNS 0331

A

85%

202
Q

Local recurrence per ACNS 0331

A

2-4% (no difference if IF boost)

203
Q

Which lesions of suspected NGGCT do not require bx?

A

bifocal pineal and suprasellar tumors

pineal with DI

204
Q

What did NGGCT study conclude about whole ventricle vs. CSI

A

More relapses, not recommended

Standard remains 36 Gy CSI –> boost to 54

205
Q

What stage of kidney rhabdoid tumor should get RT

A

I-III (19.8 Gy)

206
Q

Doses for Wilms tumors with anaplasia

A

Stage III with diffuse anaplasia –> 19.8
Stage I-III with focal anaplasia –> 10.8
Stage I-II with diffuse anaplasia –> 10.8
Stage I-III clear cell sarcoma of kidney –> 10.8

207
Q

RT dose for residual Wilms disease measuring > 3cm

A
  1. 5 whole abdomen

10. 5 boost

208
Q

Peak incidence of Wilms

A

3-4 years for unilateral

209
Q

Denys-Drash syndrome etiology

A

WT1 gene on chromosome 11

210
Q

Denys-Drash symptoms

A

Wilms
pseudohermaphroditism
masangial renal sclerosis

211
Q

Beckwith-Widemann symptoms

A 
macroglossia
macrosomia
midline abdominal wall defects
ear creases
neonatal hypoglycemia
hemihypertrophy
212
Q

Prognosis of favorable histology WIlms

A

> 90% unless stage IV (80%)

213
Q

Chemo for Ewing

A 
VAC-IE
Vincristina
Adriamycin
Cytoxan
Ifos
Etop
214
Q

Local failure risk after RT for Ewing

A

overall 10-20% but site dependent

pelvis is 20-30%

215
Q

Preferred treatment for low grade osteosarcoma

A

wide surgical excision

216
Q

Preferred mgmt of high grade osteosarcoma

A

neoadjuvant chemo –> surgical resection –> adjuvant RT if +margins or significant necrosis

217
Q

What chemo is used for osteosarcoma

A

MAP - methotrexate, adriamycin, cisplatin

218
Q

Study of 36 Gy vs. 23.4 Gy for standard risk medullo without chemo concluded?

A

Higher relapse rate in 23.4 Gy arm

219
Q

Typical IHC markers for rhabdo

A

Myogenin

MyoD1

220
Q

Tumors positive for S100 staining

A

melanoma
schwannoma
MPNST

221
Q

Rate of incidentally detected pulm nodules in otherwise healthy children

A

40%

222
Q

What dose of HPA RT can cause altered puberty timing?

A

18-24 Gy

223
Q

What is threshold of developing gonadotropin insufficency?

A

> 30 Gy

224
Q

Mutation associated with embryonal rhabdo

A

DICER1

225
Q

Surgery for Wilms

A

radical nephroureterectomy with ipsilateral LN sampling

226
Q

Proportion of Ewing sarcoma patients metastatic at diagnosis

A

20-25%

227
Q

Regimen for medullo if patient cannot get chemo

A

36 Gy CSI

PF boost to 55.8

228
Q

Locations of bifocal germinoma

A

Pineal gland

Suprasella

229
Q

Locations of trilateral retinoblastoma

A

Bilateral retina

Pineal

230
Q

RT doses used for trilateral RB

A

36 Gy spine
45 Gy cranium
50.4 to pineal

231
Q

Is hereditary RB dominant or recessive?

A

dominant

232
Q

Ewing sarcoma radiographic finding

A

onion skinning

233
Q

Osteosarcoma radiographic finding

A

sunburst pattern near metaphysis

234
Q

Where should optimal CSI match line be

A

as low as possible to avoid PA exit through mouth

usually C5-6

235
Q

How is spinal disease boosted for high risk medullo

A

total of 45 Gy if above the terminus

50.4 Gy if below terminus

236
Q

Role for RT in GTR of LGG

A

none

237
Q

Most common cancer of teenagers

A

Hodgkin lymphoma

238
Q

Osteosarcoma epidemiology

A

More common in Males/Blacks

Bimodal - teens and 65+

239
Q

Treatment approach for pineoblastoma

A

Similar to high risk medullo
36 Gy CSI with conucrrent vincristine
IF boost to 55.8
Adjuvant cis based chemo

240
Q

How to manage bifocal germinoma

A

Platinum chemo followed by full ventricle RT

24 Gy WVRT followed by boost to 45

241
Q

Dose of RT for neuroblastoma cord compression

A

Under age 3: 9 Gy (1.8 x 5)

Over age 3: 21.6 Gy

242
Q

What is whole lung dose for Wilms

A

12 Gy

243
Q

Which Wilms patients should get whole lung

A

unfavorable histology and lung mets visible on CXR (anaplasia)
if FAVORABLE histology –> chemo

244
Q

For Wilms lung lesions - if visible on CT only they should be > X mm in order to get WLI

A

10 (1 cm)

245
Q

Which low risk T-ALL patients need cranial RT

A

CNS 3

246
Q

Dose of RT for CNS 3 disease

A

18 Gy in 10 fx

247
Q

When do CNS 1 and 2 get PCI

A

intermediate/high risk

248
Q

Dose of PCI

A

12 Gy in 1.5 Gy fx

249
Q

Tyoical PCI field

A

brain and 1/2 globes and optic nerves

inferior border is c2/c3

250
Q

Treatment of intracranial NGGCT

A

36 Gy CSI

Boost to 54 (1.8 Gy per fx)

251
Q

Treatment of intracranial germinoma

A

24 Gy whole ventricle

Boost to 45 (1.5 Gy per fx)

252
Q

Which hormone usually declines first after irradiating pituitary

A

GH
Followed by FSH/LH
TSH/ACTH later

253
Q

Median age of ependymoma

A

3-5 years old

254
Q

Median age of medullo

A

5-9 years old

255
Q

Inferior border of CSI

A

bottom of thecal sac

256
Q

What stage is a wilms which was biopsied but is otherwise intact

A

stage III

257
Q

Like what tumors are supratentorial neuroepithelial tumors managed?

A

High risk medulloblastoma

36 Gy CSI + 19.8 Gy boost to PF

258
Q

What is current COG protocol testing for high risk medullo

A

Efficacy of carboplatin with RT and isotretinoin as pro-apoptotic agent

259
Q

Current chemo regimen for rhabdo

A

VAC
Vincristine
ACTINOMYCIN
Cyclophosphamide

260
Q

Dose for orbital rhabdo

A

45 Gy if CR to VAC chemo

50.4 Gy if PR to chemo

261
Q

What stages of Wilms with focal anaplasia should get RT

A

I-IV

262
Q

Mutation associated with ATRT

A

INI-1

SMARCB1 gene family

RO Clinical Boards (13 decks)

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