Radiation Oncology/CNS/Introduction



Survival

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2-year and 5-year OS of various primary CNS tumors:

  • Astrocytoma, Pilocytic WHO grade I - 90%
  • Astrocytoma WHO grade II - 66%
  • Astrocytoma WHO grade III - 45% and 34%
  • GBM - 9%
  • Oligodendroglioma - 81% and 65%
  • Medulloblastoma - 66% and 60%
  • Ependymoma - 83% and 60%


Tumors that might be irradiated without pathologic diagnosis

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  • Optic glioma
  • Diffuse pontine glioma
  • Meningioma
  • Choroidal melanoma


CNS tumors that are most likely to metastasize outside the CNS

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  • Glioblastoma
  • Medulloblastoma
  • Ependymoma
  • Hemangiopericytoma
  • Meningioma

Pathologic correlations

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  • Rosenthal fibers - JPA
  • Psammoma bodies - meningioma (and papillary tumors such as thyroid or endometrial)
  • Verocay bodies - schwannoma
  • Schiller Duval body - yolk sac tumor
  • Fried egg appearance - oligodendroglioma
  • Pseudorosettes (central lumen not formed by the growth itself, unlike a rosette) - ependymoma, but also PNET, medulloblastoma
  • Homer-Wright rosette - PNET, medulloblastoma, pineoblastoma, neuroblastoma
  • Flexner-Wintersteiner rosette - retinoblastoma