Central Nervous System Cancers, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Abstract

The NCCN Guidelines for Central Nervous System (CNS) Cancers focus on management of adult CNS cancers ranging from noninvasive and surgically curable pilocytic astrocytomas to metastatic brain disease. The involvement of an interdisciplinary team, including neurosurgeons, radiation therapists, oncologists, neurologists, and neuroradiologists, is a key factor in the appropriate management of CNS cancers. Integrated histopathologic and molecular characterization of brain tumors such as gliomas should be standard practice. This article describes NCCN Guidelines recommendations for WHO grade I, II, III, and IV gliomas. Treatment of brain metastases, the most common intracranial tumors in adults, is also described.

Integrated Analysis of the Clinical and Molecular Characteristics of IDH Wild-Type Gliomas in the Chinese Glioma Genome Atlas

“…In addition, our study only included newly diagnosed patients and excluded recurrent GBM patients, which may also produce a certain bias for this later group. Currently, treatment regimens for IDH-wt LGG in the NCCN treatment guidelines tend to be consistent with GBM, and the 3 rd version of cIMPACT-NOW indicates that when IDH-wt diffuse astrocytoma has certain molecular pathological characteristics, it can be considered a WHO grade IV glioma; however, through our analysis of clinical information, molecular pathology and gene expression, we found that there are still many differences between IDH-wt LGG and GBM [12,13] Conclusion:…”

“…In addition, in the third cIMPACT-NOW report, the committee recommended reclassifying IDH1/2 wild-type diffuse lower-grade gliomas of WHO grade II and III (LGG) as diffuse astrocytic glioma, IDH1/2-wt with molecular features of glioblastoma [12]. Moreover, NCCN guidelines recommend that IDH wild-type LGG be treated using therapy typical for GBM [13]. However, according to the above reports and the latest literature, as well as our data, we found that IDH-wt LGG and IDH-wt GBM may have differences in their prognoses and molecular features such as TERT promoter mutation and EGFR ampli cation, which may lead to differences in treatment [12,14].…”

A Radiomics nomogram for preoperative predicting recurrence of low grade gliomas based on multiparametric MRI

“…There are also some limitation in the study:1)according to Central Nervous System Cancers, Version 3.2020, National Comprehensive Cancer Network (NCCN), Clinical Practice Guidelines in Oncology [25],there is a lack of high-level evidence-based medical evidence for the survival bene ts of secondary surgery in patients with recurrent glioma,so the major patients with glioma recurrence after surgery choose radiotherapy and chemotherapy in our institution,it means the recurrent tumor biopsy is di cult to acquire, RANO criteria is applied to selected case,but the total sample is still small,longer time and more available cases will be conducted in the future studies;2)Variety life habits, mental state and other factors that may affect tumor recurrence can not be excluded, which is also a di culty encountered in many studies;3)so far there is few studies and still di cult to illustrate the relationship between the image feature and pathology of tumor,it deserves further study.…”

Breast Cancer Brain Metastasis—Overview of Disease State, Treatment Options and Future Perspectives

“…Neurosurgical resection, stereotactic radiosurgery (SRS), and whole brain radiation therapy (WBRT) are the current standard local therapy treatments for BCBM. The local treatment strategies for BCBM depend on the patients’ performance status and number/size/location of the brain tumor [ 37 , 38 ]. Table 1 (major clinical trials) and Supplementary Materials Table S1 (other clinical trials) show main clinical trials in radiation therapy.…”