Neurological oncology

Neurological oncology encompasses the diagnosis and management of primary and metastatic tumours of the nervous system as well as the effects of cancer and cancer treatments on the nervous system. Primary central nervous system (CNS) tumours are graded from grade I to grade IV according to the World Health Organization Classification. High-grade tumours (grades III and IV) benefit from maximal surgical resection and, in general, subsequent treatment with chemotherapy and radiotherapy is indicated. Median survival is about 14 months although 25% survive for 2 years. Grade II tumours have a median survival of 5–9 years. Systemic cancer can affect the nervous system directly through metastatic disease or indirectly through paraneoplastic neurological syndromes or adverse effects of cancer treatments. The management of primary CNS tumours should be discussed by the neuro-oncology multidisciplinary team and the management of metastatic disease should be discussed by the multidisciplinary team responsible for the primary cancer site.