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34

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

3

Astrocytomas

Diffuse astrocytomas

Guide 4. Follow-up care

Test

Test schedule

Brain MRI

ª

• Every 3–6 months for 5 years

◦◦ If results are stable, then repeat every year

Guide 5. Progression or recurrence

You didn’t have radiation therapy before

Your surgery status

What are the options?

Approved and agree to surgery

ª

Surgery

ª

• Fractionated EBRT + chemotherapy

ª

• Fractionated EBRT

ª

• Chemotherapy

Not approved or decline surgery

ª

• Fractionated EBRT + chemotherapy

ª

• Fractionated EBRT

ª

• Chemotherapy

You did have radiation therapy before

Your surgery status

What are the options?

Approved and agree to surgery

ª

• Surgery followed by chemotherapy

Not approved or decline surgery

ª

• Chemotherapy

What are the options if the cancer progresses after chemotherapy?

• A different chemotherapy

• Radiation therapy again

• Best supportive care