Table 2. Adjuvant treatment for glioblastoma patients by KSNO, NCCN, and EANO guideline.
Guidelines | Adjuvant treatment |
---|---|
KSNO | 1) For patients age >70 & KPS ≥60: CCRT (hypofractionated or standard) & adjuvant temozolomide |
2) For patients age >70 & KPS <60: RT alone (hypofraction) or temozolomide (MGMT methylated patient) | |
3) For patients age ≤70 & KPS ≥60: CCRT (standard) & adjuvant temozolomide | |
4) For patients age ≤70 & KPS <60: RT (hypofraction) ± concurrent or adjuvant temozolomide | |
NCCN | 1) For patients of age ≤70 & KPS ≥60, without consideration of the methylation status of MGMT promoter: CCRT & adjuvant temozolomide ± TTF |
2) For patients of age ≤70 & KPS <60, without consideration of the methylation status of MGMT promoter: hypofractionated RT ± concurrent or adjuvant temozolomide | |
3) For patients of age >70, KPS ≥60 & methylated MGMT promoter: hypofractionated RT + concurrent or adjuvant temozolomide | |
4) For patients of age >70, KPS ≥60 & unmethylated MGMT promoter: CCRT & adjuvant temozolomide ± TTF | |
5) For patients of age >70 & KPS <60: hypofractionated RT alone | |
EANO | 1) Temozolomide CCRT (54–60 Gy in 1.8–2.0 Gy fractions) |
2) For patients aged >65–70 years and MGMT unmethylated tumors: RT (40 Gy in 2.67 Gy fractions) | |
3) For patients aged >65–70 years and MGMT methylated tumors: temozolomide CCRT or temozolomide |
CCRT, concurrent chemoradiotherapy; EANO, European Association of Neuro-Oncology; KPS, Karnofsky Performance Scale; KSNO, Korean Society for Neuro-Oncology; MGMT, O6-methylguanine-DNA-methyltrasferase; NCCN, National Comprehensive Cancer Network; RT, radiotherapy; TTF, tumor treating fields