The NCCN guidelines update combines adjuvant treatment options for low- and high-risk adult patients with low-grade infiltrative supratentorial astrocytoma/oligodendroglioma after maximal safe resection.
May alter post-resection care via combined adjuvant options and revised risk criteria; extends NCCN guidelines for low-grade gliomas.
include:Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma (Excluding Pilocytic Astrocytoma) ASTR-1• After "Maximal safe resection," the adjuvant treatment options for low-risk and high-risk patients were combined.Previously, low-risk patients were only "Observed" after maximal safe resection.• Footnote "h" was revised as follows: "High-risk features: 3 or more of:Astrocytoma, age >40 y, KPS <70, tumor dimension >6 cm, tumor crossing midline, preoperative neurological deficit of more than minor degree.One or no deletions on 1p and 19q, IDH1 or 2 not mutated, increased perfusion on imaging are also adverse factors that may be considered."ASTR-2• No prior fractionated external-beam pathway: the term "progression" was removed.
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