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51

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Guide 13

addresses follow-up care. Follow-up care

is started when your doctor thinks the cancer has

been fully treated. A brain MRI is advised every 3 to

6 months for 5 years. If results are stable for 5 years,

a brain MRI is needed every year. If you can’t have

MRI, you may receive a CT scan with and without

contrast.

Guide 14

lists treatment options for cancer

progression or recurrence. In addition, a clinical

trial may be another option. Cancer progression is

further growth or spread of cancer that’s already

been found. A recurrence is the return of cancer after

not having signs of cancer for a period of time. Your

surgeon may obtain a tissue sample to confirm the

cancer’s back and to assess the cancer grade.

Progressive and recurrent cancers are treated

the same. Options are based on whether you

had fractionated EBRT when first treated. If you

will receive chemotherapy, it may consist of PCV,

temozolomide, lomustine, carmustine, or platinum-

based regimens.

No radiation therapy before

Your surgeon will assess if surgery is an option. If

you undergo surgery, get a brain MRI within 24 to

72 hours to assess surgery results. If you can’t have

MRI, you may receive a CT scan. Images will be

made with and without contrast.

After surgery, observation may be started if all the

cancer was removed. However, for most people,

surgery should be followed by fractionated EBRT

with or without chemotherapy or followed by

chemotherapy only. Chemotherapy may have good

results for grade II oligodendroglioma, especially

if the cells have 1p19q deletions. However, more

research is needed to know for certain.

If surgery isn’t an option, you may have three

options. One option is fractionated EBRT with

chemotherapy. The second option is fractionated

EBRT without chemotherapy. A third option is

chemotherapy only. Chemotherapy may have good

results for grade II oligodendroglioma, especially

if the cells have 1p19q deletions. However, more

research is needed to know for certain.

Radiation therapy before

Your surgeon will assess if surgery is an option. If

you undergo surgery, get a brain MRI within 24 to

72 hours to assess surgery results. If you can’t have

MRI, you may receive a CT scan. Images will be

made with and without contrast.

Chemotherapy should be received after surgery or as

the sole treatment if surgery isn’t an option. During

chemotherapy, get MRI scans every 2 to 3 months to

assess treatment results.

The cancer may progress after chemotherapy. In this

case, you may have three options. One option is to

think about changing to a different chemotherapy.

Chemotherapy may have good results for grade II

oligodendroglioma, especially if the cells have 1p19q

deletions. However, more research is needed to

know for certain.

For cancer that has progressed, your radiation

oncologist may think radiation therapy is another

option. The third option is supportive care. Supportive

care aims to improve your quality of life. It includes

treatment for symptoms caused by the cancer or

prior treatment.

4

Oligodendrogliomas and oligoastrocytomas Grade II