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49

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Grade II

For older people who had a total resection and for

people who had other surgeries, you may have four

options. Starting treatment now is advised in most

cases. You may receive fractionated EBRT followed

by 6 cycles of PCV. This option had good results in a

well-designed clinical trial. EBRT with PCV is advised

when a 1p19q co-deletion is present.

A second option is fractioned EBRT followed

by temozolomide. Likewise, you may receive

temozolomide during and after fractioned EBRT.

For some people with stable or no symptoms, you

may start observation. The role of starting treatment

versus observation in low-grade gliomas is debated

among health experts.

Guide 12. 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 temozolomide

ª

• Temozolomide during and after fractionated EBRT

ª

• Observation

4

Oligodendrogliomas and oligoastrocytomas Grade II