Treatment Protocols

 

Assessment, Investigations and the Decision making process


Guidelines for Medical Decompressive Therapy


Intensity Modulated Radiotherapy (IMRT)


Stereotactic Irradiation (SRS and SRT)


>>Performance Scales

Follow-Up Policy

Primary Treatment Policies


Astrocytic Tumors (Gliomas)

Ependymomas

 

Craniospinal Radiotherapy

 

Pituitary Tumors

Craniopharyngiomas

Meningiomas

Chordomas

Primary CNS Lymphomas

Spinal Tumors

 

Brain Metastasis


Performance Scales  

 

Karnofsky Performance Score (KPS)

Neurological Performance Scale (MRC)

CPS Scale (WHO)

Barthel Activities of Daily Living (ADL) Index

Glasgow Coma Scale (GCS)

 

 

 

KPS (Karnofsky Performance Score)

  • 100% = Normal; no complaint; no evidence of disease.
  • 90% = Able to carry on normal activity; minor signs of disease.
  • 80% = Normal activity with effort, some signs or symptoms of disease.
  • 70% = Cares for self, unable to carry out normal activity or to do
    active work.
  • 60% = Requires occasional assistance, but is able to care for most of own needs.
  • 50% = Requires considerable assistance and frequent medical care.
  • 40% = Disabled, requires special care and assistance.
  • 30% = Severely disabled, hospitalization is indicated although death not imminent.
  • 20% = Hospitalization necessary, very sick, active supportive treatment necessary.
  • 10% = Moribund, fatal processes progressing rapidly.

 

Neurological Performance Scale (MRC)

  • 0 = No neurologic deficit.
  • 1 = Some neurologic deficit but function adequate for useful work.
  • 2 = Neurologic deficit causing moderate functional impairment, e.g. ability to move limbs only with difficulty, moderate dyphasia, moderate paresis, some visual disturbance (e.g. field defect).
  • 3 = Neurologic deficit causing major functional impairment, e.g. inability to use limb/s, gross speech or visual disturbances.
  • 4 = No useful function - inability to make conscious responses

 

CPS Scale (WHO)

  • 0 = Able to carry out all normal activity without restriction.
  • 1 = Restricted in physically strenuous activity but ambulatory and able to carry out light work.
  • 2 = Ambulatory and capable of all self-care but unable to carry out any work; up and about more than 50% of waking hours.
  • 3 = Capable only of limited self-care; confined to bed or chair more than 50% of waking hours.
  • 4 = Completely disabled; cannot carry out any self-care; totally confined to bed or chair.

Barthel Activities of Daily Living (ADL) Index


This is based on the following factors: 

Bowels 0 = incontinent
1 = occasional accident
2 = continent
Bladder 0 = incontinent or catheterised and unable to manage
1 = occasional accident (maximum 1x per 24 hours)
2 = continent (for over 7 days)
Grooming  0 = needs help
1 = independent - face/hair/teeth/shaving
Toilet needs 0 = dependent
1 = needs some help, but can do something
2 = independent but with some difficulty
3 = normal
Feeding 0 = unable
1 = needs help cutting, spreading butter etc.
2 = independent but slow
3 = normal 
Transfer 0 = unable
1 = major help (1-2 people, physical)
2 = minor help (verbal or physical)
3 = independent but slow
4 = normal
Mobility 0 = immobile
1 = wheel chair independent including corners etc.
2 = walks with help of 1 person (verbal or physical)
3 = independent but slower than before
4 = normal
Dressing 0 = dependent
1 = needs help, but can do about half unaided
2 = independent but has difficulties
3 = normal
Stairs 0 = unable
1 = needs help (verbal, physical, carrying aid)
2 = independent up and down but slow and with difficulty
3 = normal 
Bathing 0 = dependent
1 = independent


Glasgow Coma Scale

Eye opening

Spontaneous = 4
To speech = 3
To pain = 2
None = 1

Verbal response

Orientated = 5
Confused = 4
Occasional words = 3
Sounds but no words = 2 

No response = 1

Best motor response

Obeys commands = 5
Localises painful stimulus = 4
Flexes to painful stimuli = 3
Extends to painful stimuli = 2
No response = 1

Home

<Previous || Next>