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55

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Post-surgery treatment

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

(

K

arnofsky

P

erformance

S

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.

Guide 16

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.

4

Oligodendrogliomas and oligoastrocytomas Grade III anaplastic