Term
| what is a consideration for steroids in a DM pt to shrink down a brain tumor? |
|
Definition
| steroids will raise blood sugar level |
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Term
| when is a neoadjuvant used? |
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Definition
| if the neurosurgeon feels they can't remove a tumor easily |
|
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Term
| why does chemo not work well for brain tumors? |
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Definition
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Term
| what is prominent pathologically in a glioblastoma multiforme? |
|
Definition
| extensive necrosis and vascular proliferation |
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Term
| what are appropriate actions to take after a brain tumor have been removed? |
|
Definition
| steroids, anti-convulsants, rad-onc, and med-onc consult. |
|
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Term
| what is the rad-onc option post brain tumor removal? |
|
Definition
| fractional external beam radiation therapy |
|
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Term
| what is the med-onc options post brain tumor removal? how are the doses calculated? |
|
Definition
| cisplatinum or temozolomide [pill] (alkylating agents) 2x dose, 5/28 days (5 days on, rest of days of the month off). doses are calculated via BMI. |
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Term
| how are ADRs from tx handled post brain tumor removal? |
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Definition
| ondansetron (prevents n/v, 5HT-3; 8/10 for efficacy), compazine (3/10 for efficacy) PO’s + steroids (stabilize BBB and antiemetic) |
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|
Term
| was radiotherapy and temozolomide found to be more effective for glioblastoma? (*possible test question*) |
|
Definition
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|
Term
| what is the more sensitive neuroimaging procedure? |
|
Definition
|
|
Term
| what is the neurosx option if a brain tumor comes back? |
|
Definition
| resection of new tumor growth and placement of gliadel wafers (BCNU-coated paper) |
|
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Term
| what is the med-onc option if a brain tumor comes back (previously treated w/temozolomide)? (*possible test question*) |
|
Definition
| switch to irinotecan/bevacizumab. requires port placement. continue steroids and anticonvulsants. |
|
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Term
| what are some good resources for pts on chemo and experiencing stress? |
|
Definition
| ACS (American CA Society), IBTA (international brain tumor assn – not much involvement in US; good for support though), Imerman’s Angels (John Imerman – survived CA, set up organization to match patients up with similar tumors, same age and gender to buddy-up… VERY useful for patient camaraderie, hope) |
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Term
| if the pt has no evidence of recurrence and is still on irinotecan/bevacizumab, which is best to drop? |
|
Definition
| irinotecan, which affects bone marrow and bevacizumab is just an antiangiogenic |
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Term
| if CA recurs for a third time? |
|
Definition
|
|
Term
| if a CA pt has significant changes what do they need to do? |
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Definition
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