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CNS tumors include tumors of the ___ & ___.
brain & spine
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Only ___% of CNs tumors metastasize
1%
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CNS tumors are responsible for ___% of annual cancer deaths.
2%
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___% of CNs tumors involve the brain
80%
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___% of CNS tumors involve the spinal cord
20%
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CNS tumors is the ___ leading cause of death in children behind leukemia
2nd
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What are the 2 age groups CNS tumors affect?
3 - 12 and 50 - 80
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Are primary brain tumors common or uncommon?
uncommon
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Brain metastasis is the most common brain lesion, mainly steming from the ___.
lung
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Most spinal axis tumors are ___-____
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Most primary spinal axis tumors are ___-dural?
intra-dural
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Note:
The Etiology of CNS tumors is largely unknown. However, associations are made between:
occupational and enviromental exposures
(chemicals, rubber, pesticides, radiation)
Lifestyle & diet
(nitrates, smoking, hairdyes)
Medical conditions
(Aids, viral infections)
Genetic factors
(von Recklinghausens disease)
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What are 3 important prognostic factors?
- Age
- performance status
- tumor type
also tumor location & grade with presence or absence of necrosis
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Cranial pressure, personality changes, seizures, motor dysfunction, speech impairment, urinary incontinence, CN VI palsy are symptoms associated with a tumor located in the ___ area of the brain?
Frontal
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The following are indications of a tumor located in the ____ section of the brain:
increased cranial pressure, vision loss, seizures, weakness, memory loss, loss of touch
parietal
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the following sysmtoms is an indication of a tumor located in the ___ section of the brain :
speech disorders
seizures
loss of smell
weakness in CNV1
defective hearing
memory
Temporal
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THe following symptoms indicated a tumor in the ____ section of the brain
seizures
loss of vision
tingling
weakness
hallucinations
Occipital
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These symptoms are clinical presentations of a tumor located in the _________.
Headaches
Seizures
Difficulty with balance,
gait & ambulation,
decreased vision
mental & personality changes
short term memory loss
hallucinations
nausea & vomitting
Brain
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Are headaches with a brain tumor worse in the am or pm?
am
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These symptoms are clinical presentations of tumors in the ________
Pain - weakness - loss of sensation - bowel & bladder control problems - deterioration of motor and sensory function - decreased temperature - paralysis - impotence
Spine
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What are some of the detection & diagnosis procedures of CNS tumors?
- complete H & P
- Patients will be on steroids to decrease swelling
- Intellectual test (person, place & time)
- Coordination skills (sensations, reflexes, motor skills)
- Opthalmoscopy
- CT
- MRI
- PET
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Histopathology is more important than ____
Anatomic staging
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Primary tumors are treated _____ fields; which is 2-3cm margin to begin the shrinking for boost
conformal
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____ helps spare normal brain tissues, optic chiasm, orbits and lens
multiple beams
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____ form 50% of all CNS tumors
Gliomas
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____ arise from neuroglial cells (astroctyes)
Gliomas
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____ are the most common in adults ages 40 to 60
Gliomas
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____ occur mostly in the cerebrum
Gliomas
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_____ of the brainstem and cerebellum are more common in children.
Gliomas
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____% of spinal cord tumors are gliomas
23%
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_____ are almost exculsively found in the cerebellum of children
medulloblastoma
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What are 5 tumors of the supporting structures of the CNS?
- Meningioma
- Acoustic Neuroma
- Pituitary tumors
- Craniopharyn gliomas
- Chordomas
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_____ arise from the pia or arachnoid layers.
age is 50 or greater
most are benign
GTR
RT is post op or if tumor is not resectable
Menigiomia
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what is the dose for menigioma
50Gy
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What type of tumor arises from Schwann cells of the nerve sheath of the 8th cranial nerve.
It's benign,
May affect adjacent facial or trigiminal nerves.
Symptoms include: hearing loss, tinnitus, and unsteadiness
Acoustic Neuromas
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____ closely resemble pituitary tumors
Craniopharygiomas
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_____ are benign and usally occur before the age of 20
craniopharygioma
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_____ found at caudal or crainal ends of spinal cord
Chordomas
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Metastatic brain lesion is ___ times more common than primary brain tumors
10
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NOTE:
For mets brain tumors whole brain RT is the treatment of choice.
Dose is 30-50 Gy and is mainly pallative.
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Between what layers is the CSF fluid?
the arachnoid & pia mater
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What allows the right & left sides of hte brain to communicate?
corpus callosum
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What is the most common CNS tumor?
Brain metastasis
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What is most common primary CNS tumor?
Glioma
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What is the most common clincial brain presentation?
headaches then dizziness
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Which treatment givees us the opportunity to save as much normal tissue as possible?
IMRT
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The way a proton delivers its energy is called a
Braggs peak
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What dooes GTR stannd for?
Gross Total Regression
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What does GBM stand for?
Glioblastoma multiforme
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What type of brain tumor can metastatsis outside the skull?
Medulloblastoma
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What does IAC stand for?
Internal Auditory Canal
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What does SRS stand for?
Sterostatic radiosurgery
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What does CTV stand for?
Clinical Target Volume
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What does ICRU stand for?
International Commission of Radiaiton Units
-
What does GTV stand for?
Gross Tumor Volume
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What does PTV stand for?
Planning target Volume
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What does TV stand for?
Treated Volume
-
What does OAR stand for?
Organs at risk
-
What 2 parts can the nervous system be broken into?
CNS - Central Nervous System
PNS - Peripheral Nervous System
-
What part of the nervous system contains the brain & spinal cord
CNS
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What part of the nervous system is outside of the skull & vertebral column & incluudes cranial nerves, spinal nerves & autonmic nervous system
PNS Peripheral nervous system
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What is the largest & most complex part of the nervous system?
The brain
-
What are the 3 portions of the brain
cerebrum, cerebellum & a brain stem
-
What does the cerebrum contain?
Nerve centers associated with sensory & motor functions
-
What regulates heart rate and arterial blood pressure, body temp, water & electrolyte balance, controls hunger & regulation of bod weight, regulates sleep & wakefullness
Hypothalamus
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Structures in the general area of the diencephelon also play important roles in the
control of emotional responses
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The ___ functions as a control center for vital activities such as cardiac rate, vasomotor effects (raises and lowers blood pressure) and respiratory function
Medulla
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_____ function to carry impulses toward the nueron cell body
dendrites
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_____ function is to carry impulses away from the neuron cell body
axons
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