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Brain Tumors Flashcards

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1
Q 
86 dogs w brain tumors
41 definitive Tx (Sx, Co60 3.8-4Gyx12 MWF, I125, chemo)
7 no Tx
38 symptomatic Tx
All had neuro signs

OMST =

A

OMST = 1 mo

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2
Q 
86 dogs w brain tumors
41 definitive Tx (Sx, Co60 3.8-4Gyx12 MWF, I125, chemo)
7 no Tx
38 symptomatic Tx
All had neuro signs

MST w Sx =

A

MST w Sx = 1 mo

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3
Q 
86 dogs w brain tumors
41 definitive Tx (Sx, Co60 3.8-4Gyx12 MWF, I125, chemo)
7 no Tx
38 symptomatic Tx
All had neuro signs

MST w RT =

A

MST w RT = 5 mo

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4
Q 
86 dogs w brain tumors
41 definitive Tx (Sx, Co60 3.8-4Gyx12 MWF, I125, chemo)
7 no Tx
38 symptomatic Tx
All had neuro signs

MST w medical management =

A

MST w medical management = 2 weeks

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5
Q 
86 dogs w brain tumors
41 definitive Tx (Sx, Co60 3.8-4Gyx12 MWF, I125, chemo)
7 no Tx
38 symptomatic Tx
All had neuro signs

3 positive prognostic factors =

A

Less neurological signs
Solitary tumor
RT treatment

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6
Q

14 dogs w brian masses
4 meningiomas, 1 LSA, 1 pituitary tumor
Orthovoltage
9 39Gy RT, 5 45 Gy RT

OMST =

A

OMST = 16 mo

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7
Q

14 dogs w brian masses
4 meningiomas, 1 LSA, 1 pituitary tumor
Orthovoltage
9 39Gy RT, 5 45 Gy RT

MST w 39Gy total =

A

MST w 39Gy total = 5 mo

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8
Q

14 dogs w brian masses
4 meningiomas, 1 LSA, 1 pituitary tumor
Orthovoltage
9 39Gy RT, 5 45 Gy RT

MST w 45Gy total =

A

MST w 45Gy total = 17 mo

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9
Q

14 dogs w brian masses
4 meningiomas, 1 LSA, 1 pituitary tumor
Orthovoltage
9 39Gy RT, 5 45 Gy RT

What’s the technique to overcome skin SE?

A

3 fields technique

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10
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

OMST =

A

OMST = 11 mo

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11
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

MST in extra-axial tumor =

A

MST in extra-axial tumor = 12.4 mo

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12
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

MST in intra-axial tumor =

A

MST in intra-axial tumor = 10 mo

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13
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

MST in pituitary tumor =

A

MST in pituitary tumor = 5 mo

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14
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

___ dogs died d/t deterioration ____ days post RT

A

2 dogs

2-3 days

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15
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

___ % died of late SE (brain nectosis)

A

14%

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16
Q

83 dogs w brain masses
38Gy total RT w megavoltage manual plans
5, 7, 8, 9, 9 Gy q1w (dose escalating plan)

RT necrosis: severe rapid neuro decline over ____ days; focal necrosis & hemorrhage 2ndary to ____

A

2-5 days

vascular endothelial prolifeartion

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17
Q

29 dogs w intracranial masses
22 meningiomas, 4 gliomas, 3 choroid plexus
Co-60, 48Gy (3Gy x 16, M-F)
Whole brain target

MST =

A

MST = 8 mo

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18
Q

29 dogs w intracranial masses
22 meningiomas, 4 gliomas, 3 choroid plexus
Co-60, 48Gy (3Gy x 16, M-F)
Whole brain target

_____ dogs died d/t PD during RT

A

2 dogs died

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19
Q

29 dogs w intracranial masses
22 meningiomas, 4 gliomas, 3 choroid plexus
Co-60, 48Gy (3Gy x 16, M-F)
Whole brain target

_____ % died d/t PD/recurrence

A

76%

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20
Q

20 dogs w meningioma
Incomplete Sx + Co60 (4Gy x 12= 48Gy)

OPFS =

A

OPFS = 30 mo

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21
Q

20 dogs w meningioma
Incomplete Sx + Co60 (4Gy x 12= 48Gy)

PF (proliferative fraction) PCNA = %

A

PF PCNA = 24%

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22
Q

20 dogs w meningioma
Incomplete Sx + Co60 (4Gy x 12= 48Gy)

Progesterone receptor = ______ %

A

Progesterone R = 70%

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23
Q

20 dogs w meningioma
Incomplete Sx + Co60 (4Gy x 12= 48Gy)

Estrogen receptor = ______ %

A

Estrogens R = 0%

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24
Q

20 dogs w meningioma
Incomplete Sx + Co60 (4Gy x 12= 48Gy)

PF PCNA & progesterone ____________ correlated

A

PF PCNA & progesterone inversely correlated

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25
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) OPFS 2 years = _______ %
OPFS 2 years = 68%
26
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) Prognostic factor of PFS =
PF PCNA
27
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) 2 years PFS w PF PCNA > 24% =
42%
28
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) 2 years PS w PF PCNA < 24% =
91%
29
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) High PF PCNA ______ times more likely recur
9.1 times
30
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) 1 RI tumor = __________, ______ mo post RT
Glioma | 39 mo post RT
31
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) PCNA expressed in _______ phase
S phase
32
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) Loss of progesterone may be associated w _____ tumor
Aggressive tumor
33
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) Human common RI tumor = ________
Maningiomas
34
20 dogs w meningioma Incomplete Sx + Co60 (4Gy x 12= 48Gy) When CT or MR should be done after Sx?
within a few days | If you wait 1 week, contrast changes due to Sx become more evident.
35
31 dogs w brain meningiomas treated w Sx alone or Sx+RT (Co-60 or magavoltage) with 40-49.5Gy MST Sx alone =
7 mo
36
31 dogs w brain meningiomas treated w Sx alone or Sx+RT (Co-60 or magavoltage) with 40-49.5Gy MST w Sx + RT =
16.5 mo
37
31 dogs w brain meningiomas treated w Sx alone or Sx+RT (Co-60 or magavoltage) with 40-49.5Gy Is there sig difference bw RT type? Is there dog difference bw RT dose?
No on both RT type and RT dose
38
46 dogs w brain tumors w neurological signs treated w RT 34 had CT based RT wo Sx Total 35-52.5 Gy in 2.5-4 Gy fraction size 22 extra, 13 intra, 13 pituitary tumors Meningioma specific MST =
Meningioma specific MST = 23 mo
39
46 dogs w brain tumors w neurological signs treated w RT 34 had CT based RT wo Sx Total 35-52.5 Gy in 2.5-4 Gy fraction size 22 extra, 13 intra, 13 pituitary tumors MST w worsening sings dogs = (Unknown tumor recurrence or AE of RT)
39 mo
40
46 dogs w brain tumors w neurological signs treated w RT 34 had CT based RT wo Sx Total 35-52.5 Gy in 2.5-4 Gy fraction size 22 extra, 13 intra, 13 pituitary tumors Prognostic factors =
None | Within location, size, signs at presentation
41
42 endoscopic-assisted intracranial tumor removal in dogs & cats (33 dogs, 6 cats) (90% meningiomas, 10% others) MST for forebrain meningioma =
70 mo
42
42 endoscopic-assisted intracranial tumor removal in dogs & cats (33 dogs, 6 cats) (90% meningiomas, 10% others) MST for caudal brain meningioma =
23 mo
43
7 dogs w frontal lobe meningiomas treated w Sx + RT 5 had Sx 3 Gy x 12 = 36 Gy total (M, W, F) Megavoltage Mean ST treated w Sx + RT =
18 mo
44
7 dogs w frontal lobe meningiomas treated w Sx + RT 5 had Sx 3 Gy x 12 = 36 Gy total (M, W, F) Megavoltage Poor prognostic factor =
Frontal lobe | d/t difficulty to remove tumor b/c of olfactory bulb tumor
45
7 dogs w frontal lobe meningiomas treated w Sx + RT 5 had Sx 3 Gy x 12 = 36 Gy total (M, W, F) Megavoltage ``` WHO grade in humans G2 = G3 = Canine, feline meningiomas = Invasion of brain in type I meningioma results in prognosis equivalent to _______ meningiomas ```
G2 = atypical G3 = anaplastic/malignant Canine, feline maningiomas = G1 w G2 like behavior Invasion of brain in type I meningioma results in prognosis equivalent to atypical meningiomas
46
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` MST for non specific reasons =
19 mo
47
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` MST for specific meningioma =
30 mo
48
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` Sig difference in ST between RT alone & Sx+RT?
No difference
49
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` AE was related to =
Volume irradiated
50
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` % of primary brain tumor had 2nd brain tumor at necropsy Also % of meningioma within the 2nd brain tumors
23% progressed 2nd brain tumors | Of the 2nd brain tumor, 27% were meningiomas
51
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` % of meningiomas showed iso-hyper broad based mass on CT
89%
52
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` % of maningiomas showed moderate-marked contrast enhancement
100%
53
``` 31 dogs w brain meningiomas 3DCRT alone or Sx + RT Dx: 10 histology, 21 imaging Megavoltage 2.5-3 Gy x 15-20 = 45-54 Gy total (M-F) ``` % had well-defined margins % had moderate mass effect % had minimum peritumoral edema % ring enhancement
83% had well-defined margins 50% had moderate mass effect 67% had minimum peritumoral edema 11% ring enhancement
54
51 dogs w primary brain tumors Frameless SRS 38 meningiomas, 4 pituitary, 4 trigeminal, 3 gliomas, 1 HSA, 1 choroid plex 15 Gy x 1 OMST =
13 mo
55
51 dogs w primary brain tumors Frameless SRS 38 meningiomas, 4 pituitary, 4 trigeminal, 3 gliomas, 1 HSA, 1 choroid plex 15 Gy x 1 Disease specific MST =
16 mo
56
51 dogs w primary brain tumors Frameless SRS 38 meningiomas, 4 pituitary, 4 trigeminal, 3 gliomas, 1 HSA, 1 choroid plex 15 Gy x 1 Difference in ST bw tumor types?
No difference
57
51 dogs w primary brain tumors Frameless SRS 38 meningiomas, 4 pituitary, 4 trigeminal, 3 gliomas, 1 HSA, 1 choroid plex 15 Gy x 1 Difference in ST bw tumor size?
Yes. Smaller tumors did better.
58
51 dogs w primary brain tumors Frameless SRS 38 meningiomas, 4 pituitary, 4 trigeminal, 3 gliomas, 1 HSA, 1 choroid plex 15 Gy x 1 % showed acute grade 3 CNS AE (altered mentation)
3.9%
59
30 dogs w brain meningiomas SRT w 8Gy x 3 MST =
19 mo
60
30 dogs w brain meningiomas SRT w 8Gy x 3 ____% worsen signs ____ weeks post RT
37%, 3-16 weeks post RT
61
30 dogs w brain meningiomas SRT w 8Gy x 3 ____% died of worsen signs within 6 months
13%
62
30 dogs w brain meningiomas SRT w 8Gy x 3 Worsen signs post RT 1. _______ was predictive 2. Should be ___________
1. Normal brain volume received Rx was predictive | 2. Should be volume <1.1 cc at Rx dose
63
30 dogs w brain meningiomas SRT w 8Gy x 3 Developed ________________ AE based on transient nature & timing
Subacute demyelination
64
30 dogs w infratentorial brain tumors 3DCRT vs pred alone as Tx Variety of Rx and protocol, but more definitive RT OMST =
9.8 mo
65
30 dogs w infratentorial brain tumors 3DCRT vs pred alone as Tx Variety of Rx and protocol, but more definitive RT MST w 3DCRT =
25.2 mo
66
30 dogs w infratentorial brain tumors 3DCRT vs pred alone as Tx Variety of Rx and protocol, but more definitive RT MST w pred alone =
2.9 mo
67
30 dogs w infratentorial brain tumors 3DCRT vs pred alone as Tx Variety of Rx and protocol, but more definitive RT ____ Gy had longer ST although not sig different
> 48 Gy
68
30 dogs w infratentorial brain tumors 3DCRT vs pred alone as Tx Variety of Rx and protocol, but more definitive RT Infratentorial brain tumor in this study showed ______ outcome compared to other literature
Better | Not sig worse than cranial brain tumors

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