(HealthDay News) — The American Society for Radiation Oncology (ASTRO) has released clinical practice guidelines on the use of radiation therapy (RT) in patients with IDH-mutant, grade 2 and 3 diffuse glioma. The guidelines are published in the September-October issue of Practical Radiation Oncology.

Lia M. Halasz, MD, from the University of Washington in Seattle, and colleagues performed a systematic literature review and developed recommendations to address RT management in patients with IDH-mutant grade 2 and 3 diffuse glioma.

The guidelines strongly recommend close surveillance alone for patients with grade 2, IDH-mutant, 1p/19q codeleted oligodendroglioma after gross total resection without high-risk features.


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For grade 3, IDH-mutant, 1p/19q codeleted oligodendroglioma with any extent of surgery, adjuvant RT is strongly recommended. Adjuvant RT is strongly recommended for grade 3 astrocytoma as well.

To reduce toxicity, the guidelines strongly recommended use of intensity-modulated RT (IMRT)/volumetric modulated arc therapy (VMAT) for patients with IDH-mutant, grade 2 or 3 diffuse glioma. When IMRT/VMAT is not available, 3D conformal RT is strongly recommended for this patient group.

Assessment, surveillance, and management are recommended for toxicity management based on expert opinion.

“Adjuvant RT after surgery remains a cornerstone of therapy for patients with IDH-mutant grade 2 and grade 3 diffuse glioma to improve progression-free survival,” the authors wrote.

Several authors disclosed financial ties to the biopharmaceutical industry.

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