This guideline provides recommendations for diagnostic and therapeutic procedures for patients with malignant gliomas. We differentiate evidence-based standards from reasonable options or non-evidence-based measures that should no longer be considered. The recommendations herein should provide a framework and assurance for the choice of diagnostic procedures and therapeutic measures and aim to reduce complications from unnecessary treatment and cost. The guideline contributes to a critical appreciation of concurrent drugs with a focus on the controlled use of anticonvulsants and steroids. It should serve as a guideline for all professionals involved in the diagnostics and care of glioma patients and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in Europe. Implementation of the recommendations summarised here will need interdisciplinary structures of care for patients with brain tumours and structured processes of diagnostic and therapeutic procedures. AF and DF report no conflicts of interest. FundingThe preparation of this guideline was not funded. The members of the task force did not receive compensation for their participation. 5 SummaryThis guideline provides recommendations for the diagnostic and therapeutic procedures for patients with malignant gliomas. It differentiates evidence-based standards from reasonable options or non-evidence-based measures that should no longer be considered. The recommendations herein shall provide a framework and assurance for the choice of diagnostic procedures and therapeutic measures and aim to reduce complications from unnecessary treatment and cost. The guideline will contribute to a critical appreciation of concurrent medications with a focus on the controlled use of anticonvulsants and steroids. It shall serve as a guideline for all professionals involved in the diagnostics and care of glioma patients and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in Europe. Implementation of the recommendations summarized here will require interdisciplinary structures of care for brain tumor patients and structured processes of diagnostic and therapeutic procedures. Key wordsAnaplastic, glioma, glioblastoma, surgery, radiotherapy, temozolomide, bevacizumab Search strategy and selection criteriaThis guideline was prepared by a task force assembled by the Executive Committee of the European Association for Neuro-Oncology (EANO) in 2013. The task force was designed to represent the different disciplines involved in the diagnosis and care of malignant glioma patients as well as to reflect the multinational composition of EANO.References for this review were identified through searches of PubMed with the search terms "glioma", "anaplastic", "glioblastoma", "trial", "clinical", "radiotherapy" 6 and "chemotherapy" from January 2005 to January 2013. Articles were also identified through searches of the authors` own files. Onl...
Although TMZ (both arms combined) did not show a clear benefit compared with PCV, comparison of the TMZ schedules demonstrated that the 21-day schedule was inferior to the 5-day schedule in this setting. This challenges the current understanding of increasing TMZ dose-intensity by prolonged scheduling.
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