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NCCN Guidelines for Patients



Brain Cancer – Gliomas, Version 1.2016







Grade I pilocytic astrocytomas are often cured

with surgery.



Surgery is often used to confirm the diagnosis

and treat astrocytomas of all grades. If the

cancer is grade III or IV, carmustine wafers

placed into your brain during surgery may be

an option. MRI is needed after major surgery to

assess how much of the cancer was removed.



More treatment is often received after surgery.

Only some grade II astrocytomas may be

observed rather than treated. Deciding

factors for more treatment differ between

cancer grades. In general, radiation therapy,

chemotherapy, or both are received. Alternating

electric field therapy may be added to treatment

for glioblastomas.



MRI scans are needed on a regular basis to

track treatment results.



If a grade II astrocytoma returns, surgery may

be an option. Treatment after surgery depends

on your treatment history. You may receive

radiation, chemotherapy, or both. Likewise,

radiation, chemotherapy, or both may be

received if surgery isn’t an option.



If a grade III or IV astrocytoma returns,

treatment options depend on where the cancer

is and its extent. Surgery may be an option

followed by chemotherapy, radiation, or for

glioblastoma, alternating electric field therapy.

When surgical treatment isn’t an option, other

options include chemotherapy, surgery for

symptoms, alternating electric field therapy

(glioblastoma), and supportive care.