Brain tumor
WHO Histologic Classification of CNS tumors: Neuroepithelial Tumors Astrocytic tumors Oligodemdroglial tumors Ependymal tumors Mixed gliomas Choroid plexus tumors Neurologic tumors Pineal parenchymal tumors Embryonal tumors Tumors of cranial/spinal nerves Mesenchymal tumors, benign Mesenchymal tumors, malignant Uncertain histogenesis Hemopoietic neoplasms Cysts/tumorlike lesions Sellar tumors
Prognostic Factors: for malignant astrocytomas Age Tumor type Performance status Extent of surgery
Principles of Treatment: Surgery: initial treatment Radiotherapy Chemotherapy Combine treatment
Estimated Survival: 5 years (%) Astrocytoma Grade I (cerebellar) 90-100 - Grade I (all sites) 50-60 Grade II 16-46 - Grade III 10-30 Grade IV 0-10 Medulloblastoma 40-50 Ependymoma 40-55 Oligodendroglioma 50-80 Brain stem 20-30 3rd ventricle+midbrain 25-35 Pinealoma 50-90
Roles of Radiotherapy in Brain Tumor Incomplete surgery Deep seated tumor: midbrain, pons Radiosensitive tumor: medulloblastoma Pituitary adenoma Palliation: metastatic lesions
Roles of Whole Cerebrospinal Axis Irradiation: Medulloblastoma Ependymoma: esp. poorly differentiated type Malignant glioma of posterior fossa Pinealoma Choroid plexus papilloma Reticulum cell sarcoma of the brian
Complications and Late Effects of Radiation: Acute reaction Brian edema Early delayed reaction Necrotizing leukoencephalopathy Somnolence Syndrome Late delayed reaction Cerebral Necrosis Optic nerve injury