CNS Test 1/14

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Author:
RadiationTherapy
ID:
192629
Filename:
CNS Test 1/14
Updated:
2014-01-03 16:12:48
Tags:
CNS Oncology radiation therapy
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CNS Test 1/14
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  1. What are the 3 types of gliomas?
    • Astrocytomas (low & high grade)
    • Oligodendroglioma
    • Ependymoma
  2. C.S.I.
    Cranio-Spinal Irradiation
  3. What is the most common type of glioma?
    Astrocytoma
  4. How long after treatment does radiation myelitis occur?
    6 mo - 2 years
  5. What is the 2nd most common type of primary brain tumor? (after gliomas)
    Meningiomas
  6. The pituitary gland sits in the ______ ______
    Sella Turcica
  7. What are the age groups effected by primary brain cancer?
    • 3-12
    • 50-80
  8. Most _______ brain lesions are intra-dural
    Primary
  9. Most _______ brain lesions are extra-dural.
    Metastatic
  10. Almost all patients are prescribed ______ as soon as they are diagnosed with a brain lesion.
    • Corticosteroids
    • ie: Prednisone
  11. Symptom: Personality changes

    Where is the cancer?
    Frontal lobe
  12. Symptom: Loss of touch

    Where is the cancer?
    Parietal lobe
  13. Symptom: Loss of hearing, smell, speech

    Where is the cancer?
    Temporal lobe
  14. Symptom: Loss of vision, Hallucinations

    Where is the cancer?
    Occipital lobe
  15. Symptom: Paralysis, Bladder/Bowel issues, Lower temp, sensation
    Where is the cancer?
    Spine
  16. The ______ performance scale runs from 100 (walkie/talkie) to 0 (dead) to describe a patients ability to function
    Karnofsky Performance Scale
  17. Primary tumor volume treated with conformal filds with a _____ margin, shrinking for boost.
    2-3 cm margin
  18. __________ is more important than anatomic staging
    Histopathology
  19. Forms 50% of all CNS tumors
    Gliomas
  20. Gliomas occur mainly in the ______ in adults
    Cerebrum
  21. Gliomas of the _____ and _____ are more common in children
    Cerebellum & Brainstem
  22. Name that tumor!
    Low grade (I-II)
    GTR followed by obs.
    If it progresses: xrt 50-55 Gy
    Astrocytoma
  23. Name that tumor!

    High grade (III-IV)
    GTR
    xrt 60-70 Gy
    Chemo BCNU
    • Astrocytoma
    • Glioblastoma Multiforme (GBM)
  24. Name that tumor!
    Slow grow
    Frequently have astrocytic mixtures
    GTR
    xrt 60-70 Gy
    Oligodendroglioma
  25. Name that tumor!
    More common in children
    Seeds through CSF in subarachnoid space & down the spinal cord
    GTR
    xrt 54-59 Gy
    C.S.I. sometimes needed
    Ependymoma
  26. Name that tumor!
    Found almost only in cerebellum of children
    Fast grow, undifferentiated, invasive through subarachnoid space, Radiosensitive.
    Capable of Metastasis
    GTR
    xrt 30-36 Gy whole brain & spine;
         20-25Gy tumor boost
    Medulloblastoma
  27. Name that tumor!
    Arises from the pia or arachnoid layers, Benign; Age 50 +
    GTR
    xrt 50Gy post op or if tumor is inoperable
    Meningioma
  28. Name that tumor!
    Originate from Schwann cells of the eighth cranial nerve
    Affect adjacent facial & trigeminal nerves
    Unilateral hearing loss, tinnitus, vertigo
    GTR
    SRS 18Gy in 3 fx
    • Acoustic neuromas 
    • (aka. Schwannomas)
  29. Name that tumor!
    Benign but locally invasive
    Slow grow
    GTR
    SRS 25 Gy in 5 fx       or
    standard xrt 45 Gy
    Pituitary tumors
  30. Name that tumor!
    Age 20 & under
    Common symptom: decreased vision/field cut
    Closely resemble pituitary tumors
    GTR if possible
    SRS 25 Gy in 5 fx
    standard xrt 45 Gy
    Craniopharyngioma
  31. Name that tumor!
    Found at the cranial or caudal end of spinal cord; Benign but locally invasive, behave malignant; Poor prognosis; Tend to regrow 
    GTR if possible
    xrt 50 Gy
    Chordomas
  32. P.C.I.
    Prophylactic Cranial Irradiation
  33. Approx ____% of patients dying of cancer have brain metastasis
    25%
  34. Patients with this type of cancer are often given PCI:
    Small cell (oat cell) lung cancer
  35. Brain metastasis: 
    Treatment of choice?
    • Whole brain xrt 30-50 Gy
    • usually inoperable
  36. When treating children, be sure to distribute the dose ______ across the skull to avoid disfiguring them.
    Uniformly, evenly
  37. Tumors of the midbrain, third ventricle, brain stem: which treatment is preferred, surgery or xrt?
    • Radiation therapy
    • areas too delicate or inaccessible for surgery
  38. Many chemo drugs are ineffective due to the __________
    Blood Brain Barrier (BBB)
  39. I.C.P.
    Inter-Cranial Pressure
  40. Which area of the brain provides a better prognosis for a low grade astrocytoma?
    Cerebellum (90% at 5 years)

    Cerebrum (46% at 5 years)
  41. XRT of a pituitary tumor can lead to ______ _______ syndrome
    Empty sella syndrome
  42. Temporary hair loss occurs from:
    20 Gy - 40 Gy
  43. Permanent hair loss occurs after:
    40 Gy

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