NCCN Guidelines for Patients
Brain Cancer – Gliomas, Version 1.2016
Grade III anaplastic
Anaplastic oligodendrogliomas are rare in adults
but have a better outlook than other grade III
gliomas. Surgery is very important for diagnosis
and treatment. The goals of surgery are to remove
enough tissue for testing, relieve symptoms, extend
life, and decrease the need for corticosteroids.
Corticosteroids are used to reduce swelling in the
lists treatment options for anaplastic
oligodendrogliomas and oligoastrocytomas. Your
surgeon will assess how much of the tumor he or
she can remove. The amount that will be removed
depends on where the tumor is, your age and health,
and other factors. Your surgeon does not want you to
be less able to think, speak, and move afterward.
Maximal safe resection
A maximal safe resection is a treatment plan to
remove all or most of the tumor as is safe. Hopefully,
the whole tumor will be removed. Many grade III
oligodendrogliomas can be fully removed. Removal
of the whole tumor is called a gross total resection.
During surgery, your surgeon may decide that the
whole tumor can’t be removed. Removing only part
of the tumor is called a subtotal resection.
Placement of carmustine wafers during surgery
may be an option. Wafers are sometimes used
for high-grade gliomas. Carmustine is a type of
chemotherapy. The wafers will be placed into the
space where the tumor was and will dissolve after
the surgical cut is closed.
Research has shown that this added treatment
helps extend life. However, if you receive more
chemotherapy after surgery, you may have more
severe side effects than if you hadn’t had carmustine.
Also, you may not be able to join some clinical trials
because you received carmustine wafers.
Sometimes, the tumor can’t be fully removed
because it is in a key area of the brain. There are
other options if it is known before surgery that
a maximal safe resection can’t be done. These
options are a subtotal resection, open biopsy, and
Guide 15. Diagnosis and treatment
Your surgery status
What are the options?
Approved and agree to removing most of the tumor
• Maximal safe resection ± carmustine wafer
Approved and agree to removing some of the tumor
• Stereotactic biopsy
• Open biopsy
• Subtotal resection
Oligodendrogliomas and oligoastrocytomas Grade III anaplastic