NCCN Guidelines for Patients
Brain Cancer – Gliomas, Version 1.2016
Guide 15 also lists options for treatment after
surgery. Options are based on your performance
status, which is your ability to do activities. The KPS
tatus) is a rating system
used to score performance status. Scores range from
0 to 100. The lower the score, the less able you are
to care for yourself.
Performance status: KPS ≥60
If there’s 1p19q co-deletion, fractionated EBRT with
chemotherapy is advised. PCV may be received
either before or afterward. Temozolomide can be
received during and after EBRT.
You may have three options if there’s one or no
1p19q deletions. Fractionated EBRT is one option.
The second option is to receive temozolomide during
and after EBRT. The third option is chemotherapy
with either PCV or temozolomide.
Performance status: KPS ≤59
You may have three options if your KPS score
is 59 or less. One option is to receive EBRT.
Hyperfractionated is preferred over fractionated
radiation. Another option is chemotherapy with PCV
or temozolomide. 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 its treatment.
addresses follow-up care. Follow-up care
is started when your doctor thinks that the cancer
has been fully treated. Get a brain MRI at 2 to 6
weeks after radiation therapy has ended. Images will
be made with and without contrast.
At first, your brain may look worse in the scans
because of the radiation. However, these results may
not mean that the cancer is growing. Instead, early
scans are used to give you the right dose of steroids.
Later scans are used to find any new brain tumors
early. A brain MRI is needed every 2 to 4 months for
2 to 3 years. If these results are stable, then MRIs
are needed less often. If you can’t have MRI, you
may receive a CT scan with and without contrast.
Oligodendrogliomas and oligoastrocytomas Grade III anaplastic