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44

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Guide 11. Recurrence

The cancer isn’t widespread

Your surgery status

What are the options?

Approved and agree to surgery

ª

• Surgery ±

carmustine wafer

ª

• Chemotherapy

ª

• Radiation therapy again

ª

• Alternating electric field therapy

ª

• Best supportive care

Not approved or decline surgery

ª

• Best supportive care

The cancer is widespread

Your performance status

What are the options?

KPS ≥60

ª

• Chemotherapy

ª

• Surgery for large tumors causing symptoms

ª

• Alternating electric field therapy

KPS ≤59

ª

• Best supportive care

Guide 10. Follow-up care

Test

Test schedule

Brain MRI

ª

• At 2–6 weeks after radiation therapy has ended

◦◦ If results are stable, then repeat every 2–4 months for 2–3 years

◦◦ If results are stable, then repeat less often

3

Astrocytomas

Glioblastomas and gliosarcomas