Table 4. Adjuvant treatment for patients with WHO grade 3 anaplastic astrocytoma, IDH-wildtype 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* | - For patients with KPS ≥60 | |
| 1) Standard RT & followed adjuvant temozolomide chemotherapy | ||
| 2) Standard RT with concurrent & adjuvant temozolomide chemotherapy | ||
| - For patients with KPS <60 | ||
| 1) RT (hypofractionated) | ||
| 2) Temozolomide (category 2B) | ||
| 3) Palliative/best supportive care | ||
| EANO | 1) RT (54–60 Gy in 1.8–2.0 Gy fractions) | |
| 2) Temozolomide CCRT according to MGMT promoter methylation status | ||
*Same guideline for patients with WHO grade 3 anaplastic astrocytoma, IDH-mutant. 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; WHO, World Health Organization