Table of Contents Table of Contents
Previous Page  35 / 88 Next Page
Information
Show Menu
Previous Page 35 / 88 Next Page
Page Background

33

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

3

Astrocytomas

Diffuse astrocytomas

Diffuse astrocytomas

Post-surgery treatment

You may have had a gross total resection and are

40 years of age or younger. In this case, you may

have 3 options. You may be able to start observation

and wait to see if more treatment is needed. Other

options include receiving fractionated EBRT or

chemotherapy now. PCV or temozolomide is advised

for chemotherapy.

For older people who had a total resection and

for people who had other surgeries, there are four

options. Starting treatment now is advised for most

cases. You may receive fractionated EBRT followed

by 6 cycles of PCV. This option had good results

in a well-designed clinical trial. A second option

is fractioned EBRT followed by temozolomide.

Likewise, you may receive temozolomide during

and after fractioned EBRT. The last option for some

people with stable or no symptoms is observation.

Guide 3. Diagnosis and treatment

Surgery

Your surgery status

What are the options?

• Approved and agree to removing most of the tumor

ª

• Maximal safe resection

• Approved and agree to removing some of the tumor

ª

• Subtotal resection

ª

• Open biopsy

ª

• Stereotactic biopsy

• Not approved or decline surgery

ª

• Observation

Post-surgery treatment

Type of surgery

What are the options?

• You had a gross total resection and

are 40 years of age or younger

ª

• Observation

ª

• Fractionated EBRT

ª

• Chemotherapy

• You had a gross total resection and

are older than 40 years of age,

• You had a subtotal resection,

• You had an open biopsy, or

• You had a stereotactic biopsy

ª

• Fractionated EBRT followed by PCV

ª

• Fractionated EBRT followed by temozolomide

ª

• Temozolomide during and after fractionated EBRT

ª

• Observation