Oligodendroglioma
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ODG; Another brain tumor, mostly on frontal area but presumably the low grade as well as high grade in nature.
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This document discusses chemotherapy for gliomas. It begins by covering early trials of carmustine for glioblastoma in the 1960s. It then summarizes the landmark 2005 Stupp trial which showed improved survival with temozolomide combined with radiation therapy for newly diagnosed glioblastoma. The document also discusses trials of bevacizumab and other targeted therapies as well as immunotherapy approaches. It reviews treatment options for recurrent glioblastoma and anaplastic glioma. Finally, it briefly discusses chemotherapy approaches and trials for low-grade gliomas in both adults and children.
Ovarian Carcinoma
Ovarian cancer is the fourth leading cause of cancer death in women. Most women are diagnosed at an advanced stage due to non-specific symptoms. While screening may detect some early stage cancers, no screening strategy has proven to reduce mortality. Standard treatment is surgical staging and debulking followed by chemotherapy with carboplatin and paclitaxel, though some studies suggest dose-dense or alternative schedules may improve outcomes.
advanced stage ovary tumor.pptx
Management of locally advanced ovarian, fallopian tube, and peritoneal tumors requires a comprehensive and multidisciplinary approach. Locally advanced tumors are those that have spread beyond the ovaries or fallopian tubes and may involve nearby structures, such as the peritoneum or adjacent organs. Here's a brief overview of the management strategies:
Surgery:
Debulking Surgery: The primary treatment for locally advanced tumors involves cytoreductive or debulking surgery. This aims to remove as much of the tumor as possible. Surgeons may perform a total hysterectomy, bilateral salpingo-oophorectomy, and removal of involved peritoneal tissues.
Lymphadenectomy: Lymph node dissection is often done to assess the extent of the disease spread and to remove involved lymph nodes.
Chemotherapy:
Neoadjuvant Chemotherapy: In some cases, chemotherapy may be administered before surgery to shrink the tumor, making surgery more effective.
Adjuvant Chemotherapy: Following surgery, chemotherapy is typically recommended to target any remaining cancer cells. Platinum-based chemotherapy regimens are commonly used.
Targeted Therapies:
PARP Inhibitors: Poly (ADP-ribose) polymerase inhibitors, such as olaparib and niraparib, have shown efficacy in treating ovarian and related cancers with specific genetic mutations, like BRCA mutations.
Immunotherapy:
Checkpoints Inhibitors: Immune checkpoint inhibitors, like pembrolizumab and nivolumab, may be considered in cases with specific molecular profiles.
Radiation Therapy:
External Beam Radiation: In some situations, radiation therapy may be used to target specific areas affected by the tumor.
Clinical Trials:
Participation in clinical trials may be an option for patients with locally advanced disease, offering access to innovative treatments and therapies.
Follow-up Care:
Regular monitoring and follow-up care are crucial to assess treatment effectiveness and detect any signs of recurrence.
Palliative Care:
Palliative care should be integrated into the management plan to address symptom control, improve quality of life, and provide support for both the patient and their family.
A personalized treatment plan should be developed based on the specific characteristics of the tumor, the patient's overall health, and individual factors. Regular communication among a multidisciplinary team, including surgeons, medical oncologists, radiation oncologists, and other specialists, is essential for optimizing the management of locally advanced ovarian, fallopian tube, and peritoneal tumors.
Cancer ovarian .pptx
This document provides information on ovarian cancer including:
1. Epidemiology statistics such as incidence rates, median age of diagnosis, and high rates of late stage diagnosis.
2. Details on cancer staging and 5-year survival rates which vary significantly based on stage.
3. Risk factors such as age, family history, and genetic mutations.
4. Guidelines that do not recommend screening for the general population due to low detection rates of early-stage cancer and potential for harm.
5. Surgical staging and debulking is the initial management approach along with chemotherapy, typically carboplatin and paclitaxel, though some studies explored improved schedules.
MANAGEMENT OF GLIOMAS
This document provides an overview of the management of gliomas. It discusses the general management and specific management of low grade and high grade gliomas.
For low grade gliomas, the main treatment options are observation, surgery, radiation, and chemotherapy. Surgery aims for maximal safe resection followed by radiation therapy. Chemotherapy with PCV may provide a survival benefit for high risk patients based on one trial, but requires further study.
For high grade gliomas, prognostic factors like age, performance status, extent of resection, and molecular markers are discussed. Treatment involves maximal safe surgery followed by concurrent chemoradiation and adjuvant chemotherapy with temozolomide, which has become the standard of care based on clinical trials
Small cell lung cancer
Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor with rapid growth and early metastasis. SCLC is usually responsive to initial chemotherapy but often relapses within two years. The standard first-line treatment is platinum-based chemotherapy such as etoposide plus cisplatin or carboplatin. Adding thoracic radiotherapy to chemotherapy improves survival for limited-stage disease. Many clinical trials have evaluated additional agents or alternative regimens but no significant improvements in outcomes have been achieved compared to standard etoposide plus platinum chemotherapy.
02 ptcl ylk
This document summarizes advances in the treatment of T cell lymphomas. It discusses that T cell lymphomas are a heterogeneous group that require different treatment strategies. Autologous stem cell transplantation improves outcomes for patients who achieve complete remission. Allogeneic stem cell transplantation may provide long-term remissions for nodal T cell lymphomas but has higher non-relapse mortality. Novel agents like romidepsin and bendamustine show promising response rates in relapsed/refractory disease. Overall, stem cell transplantation improves survival when given in the frontline or chemotherapy-sensitive setting, but optimal primary chemotherapy regimens need further refinement to get more patients to transplant.
CNS tumors_MG
The document discusses various types of primary and metastatic brain tumors. It provides statistics on the annual incidence of different brain tumors in the US. It then describes several specific tumor types in more detail, including meningiomas, vestibular schwannomas, craniopharyngiomas, gliomas such as glioblastoma, and brain metastases. For each tumor type, it discusses epidemiology, presentation, imaging, histopathology, treatment including surgery and radiotherapy techniques and dose/fractionation schedules.
Pancreatic cancer Management (pancreatic adenocarcinoma)
A 71-year-old female presented with abdominal pain and weight loss. Imaging showed a mass in the pancreatic body involving nearby vessels. This represents locally advanced, unresectable pancreatic cancer. Treatment options include chemotherapy, radiation therapy, or chemoradiation to help control symptoms and prolong survival, though the prognosis remains poor. Surgery may be considered if the tumor significantly shrinks with neoadjuvant therapy.
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This journal club presentation summarized the PRIME II randomized controlled trial which evaluated the efficacy of postoperative whole-breast radiotherapy for women aged 65 years or older with early-stage, hormone receptor-positive breast cancer treated with breast-conserving surgery and adjuvant endocrine therapy. The results showed that radiotherapy achieved a significant but relatively small reduction in local breast recurrence at 5 years compared to no radiotherapy. However, the 5-year rate of recurrence was low enough that omission of radiotherapy could be considered for select low-risk patients based on tumor characteristics and patient preferences. Treatment decisions require individualization based on prognostic factors and risk-benefit assessment.
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Oligodendroglioma
- 1. Start with the great name of ALLAH, the most beneficial and the most Merciful
- 2. 45 year male presented with behavioral changes and Seizures.
- 3. 2-4 % of all primary brain tumor 25-33% of glial tumors M:F ; 3: 2 Average 40 years (peak B/w 26-46 year) with smallest early childhood peak (b/w 6 -12 years) CSF metastasis; 10 % Spinal ODG; 2.6 % intra-medullary tumor Oligodendroglial Tumor
- 4. Oligodendroglial Tumor Presentation Seizures ; 50 – 80 % Headache; 22 % Mental status change; 10 % Vertigo/ nausea; 9 % Location Supra-tentorial ; 90 % Frontal lobe; 45 % Hemisphere (except front); 40 % With in 3rd and lateral ventricle; 15% Infra-tentorial and spine; <10%
- 5. Calcification; 90 % on CT scan T2 - weighted well circumscribed, homogeneously hyper-intense T1 weighted, contrast enhanced, heterogenously hypo- intense with no significant enhancement 70 % calcified; hypo intense on T1 and T2, but micro calcification can demonstrate hyperintense on T1 weighted Radiological Presentation
- 7. 73% micro-calcification; 16 % cystic; 33- 41 % have component of ependymal or neoplastic astrocytoma Penetrate intact parenchyma Fried egg appearance Chicken wire vascular pattern Round monotonous nuclei surrounding eccentric rim of eosinophilic cytoplasm with lacked cell process GFAP staining; mostly for astrocyte component Pathology
- 9. WHO class II (low grade) WHO class III (High Grade) Smith grading System; compose of five variables o N/c ratio o Maximal cell density o Pleomorphism; related to Survival o Endothelial proliferation o Necrosis Grading System
- 11. 1p or 19 q or both allelic loss responses on chemotherapy PVC; Procarbazine 60 mg/m2 IV, CCNU aka lomustine 110 mg/ m2 PO, Vincristine 1.4 mg/m2 all given on 29 days cycle repeated every 6 weeks. Chemotherapy
- 12. Indication of surgery Significant mass effect regardless of grade Without mass effect; low grade: gross total resection; improve survival High grade: no improvement in survival, either with gross total or partial de bulking or biopsy Pink to red friable mass, can have false plane of demarcation between tumor and normal brain parenchyma Surgery
- 13. Controversial Survival is better with > 45 Gy No improvement in 5 year survival with or with out XRT Post operative Radiation
- 14. Pure ODG have better outcome from astrocyte component Median survival; grade A; 94 months, grade B; 51 months, grade C; 45 months and grade D; 17 months 10 year survival; surgically treated mean 52 months Calcified; 108 months vs Non- calcified 58 month Frontal lobe; 37 months vs temporal lobe; 28 months Chromosome 1 p loss have longer survival Prognosis