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Brain Tumors - Background
Table 25-1.
Approximate
incidence of
common CNS
tumors in children.
Pizzo & Poplack
Location – Supra vs. Infra
Supratentorial 25-40%
Astrocytoma, low grade 8-20%
Astrocytoma, high grade 6-12%
Ependymoma 2-5%
Mixed glioma 1-5%
Ganglioglioma 1-5%
Oligodendroglioma 1-2%
PNET 1-2%
Choroid plexus tumor 1-2%
Meningioma 1-2%
Germ Cell Tumors 1-2%
Other 1-3%
Location – Supra vs. Infra
Infratentorial 45-60%
CSF dissemination
– check for leptomeningeal spread
– brain/spine MRI, LP
60-70% supratentorial
XRT has significant neuro-cognitive effects
Goal of therapies:
– Delay XRT to at least 3 yrs old with chemotherapy
most relapse prior to XRT
Current study
– Short course (16 wks) chemo
– 2nd look surgery
– Focal (conformal) XRT
– Maintenance chemotherapy
Complications From
Tumor/Therapy
Neurological deficits
– limb paresis
• Rehab/PT/OT, support
– swallowing/speech dysfunction
• ENT, Speech therapy
• Nutrition issues
– neuro-cognitive deficits
• School/education issues
• Social interaction issues
– endocrine dysfunction
– end-organ damage
• kidney, liver, hearing, neuropathy
From ABP
Certifying Exam Content Outline
Sachin Jogal MD