National Comprehensive Cancer Network

About NCCN

UPDATES: NCCN Guidelines® and NCCN Compendium®

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Senior Adult Oncology. These NCCN Guidelines® are currently available as Version 1.2014.

  • Special considerations for patients able to tolerate treatment
    • Surgery: The following statements are new to the guidelines:
      • There are data to suggest that an increased need for functional assistance pre-surgery (measured by ADL, IADL, and PS) predicts postoperative complications, extended hospital stay, and 6 month mortality in older patients undergoing cancer surgery.
      • Impaired cognitive status is a risk factor for postoperative complications, prolonged length of stay, and 6 month overall mortality postoperatively.
      • In patients undergoing general surgery, older age is a risk factor of postoperative delirium and delirium is a risk factor for functional decline
      • Yale Delirium Prevention Trial and Hospitalized Elder Life Program (HELP) and National Institute for Health and Clinical Excellence (NICE) Guideline for the Prevention of Delirium are included as preventive measures for delirium
    • Two new tools for predicting chemotherapy toxicity risk were added to the guidelines:
      • Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH)
      • Cancer and Aging Research Group (CARG) Chemo Toxicity Calculator
  • Disease-specific issues related to age
    • The following statement is new to Central Nervous System Cancers:
      • In patients with glioblastoma who are older than age 70, hypofractionated radiation therapy alone over two weeks OR Temozolomide alone each produce an OS benefit compared to standard fractionated radiation therapy over six weeks. This study also confirms the predictive benefit of MGMT promoter methylation status with temozolomide use.
    • The following statements are new to Prostate Cancer:
      • Androgen deprivation therapy significantly decreases muscle mass, and treatment-related sarcopenia appears to contribute to frailty an increased risk of falls in older men.
      • In older adults, newer hormonal therapies can potentially replace or delay the usage of cytotoxic chemotherapy and may be used in patients who would otherwise be ineligible for chemotherapy.
    • Myelodysplastic Syndromes is new to this section.
  • Comprehensive Geriatric Assessment
    • Polypharmacy: Oxybutynin was added to the class of medications that require careful review of indications, duration of therapy and dosage.
  • The following sections are new this version of the guidelines:
    • Assessment of Cognitive Function,
    • Assessment of Adherence
    • Insomnia

For the complete updated versions of the NCCN Guidelines®, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), and the NCCN Chemotherapy Order Templates (NCCN Templates®), please visit

To access the NCCN Biomarkers Compendium™, please visit

To view the NCCN Guidelines for Patients®, please visit

Free NCCN Guidelines mobile apps for iPad and Android are now available! Visit