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65

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

5

Ependymomas

Follow-up care | Return of cancer

Guide 21

addresses follow-up care. Follow-up care

is started when your doctor thinks the cancer has

been fully treated.

If you had a brain tumor, brain MRIs are needed. If

you had a spinal tumor, spinal MRIs are needed. If

cancer was found in both your brain and spine, brain

and spinal MRIs are needed. If you can’t have MRI,

you may receive a CT scan with and without contrast.

Get a MRI scan every 3 to 4 months for 1 year. If

results are stable during this first year, get scans

every 4 to 6 months for 1 year. If results are stable

during this second year, get scans every 6 to 12

months.

Guide 22

lists treatment options for a recurrence.

In addition, a clinical trial may be another option. A

recurrence is the return of cancer after a period of

time without signs of cancer. To help plan treatment,

you should receive MRIs of both your brain and spine

and a lumbar puncture.

Your surgeon will assess if surgery is an option. If

you undergo surgery, you may receive limited-field

fractionated EBRT afterward if you haven’t had

it before. Some people may receive stereotactic

radiosurgery depending on the shape of the tumor.

If surgery isn’t an option, you may have two options.

One option is limited-field fractionated EBRT if you

haven’t had it before. Some people may receive

stereotactic radiosurgery depending on the shape of

the tumor.

Testing after treatment

Brain and spine MRIs are used to assess treatment

results and if there’s cancer in other sites. If you can’t

undergo MRI, you may receive CT scans. Images will

be made with and without contrast.

If you had surgery, the timing of the MRIs is

important. The brain MRI should follow surgery within

24 to 72 hours. The spine MRI should be done 2 to 3

weeks after surgery. Images of your spine will be less

affected by surgery by then.

Guide 23

lists treatment options if the cancer

progresses after recurrence treatment. Radiation

therapy may be an option whether you had it before

or not. Some people may receive stereotactic

radiosurgery depending on the shape of the tumor.

Chemotherapy may be another option if surgery or

radiation was not successful.

Supportive care is always an option. It aims to

improve your quality of life. It includes treatment for

symptoms caused by the cancer or prior treatment.