MONDAY, Sept. 19, 2022 (HealthDay News) — In a clinical practice guideline issued by the American Society for Radiation Oncology and published in the September-October issue of Practical Radiation Oncology, recommendations are presented for the use of radiation therapy (RT) in patients with isocitrate dehydrogenase (IDH)-mutant grade 2 and grade 3 diffuse glioma.

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

The authors strongly recommend close surveillance alone for patients with oligodendroglioma, IDH-mutant, 1p/19q codeleted, World Health Organization (WHO) grade 2 after gross total resection without high-risk features. For oligodendroglioma, IDH-mutant, 1p/19q codeleted, WHO grade 3, with any extent of surgery, adjuvant RT is strongly recommended. Adjuvant RT is strongly recommended for astrocytoma, WHO grade 3. Consideration for advanced techniques such as intensity-modulated radiation therapy/volumetric-modulated arc therapy or proton therapy were given as strong and conditional recommendations, respectively, in view of the known adverse long-term effects of RT. 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 write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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