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Brain tumor. 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
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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 WHO Histologic Classification of CNS 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