ينطبق هذا البروتوكول على البالغين المصابين بالأستروسيتوما اللابلاستية، الدرجة 3 حسب تصنيف WHO للجهاز العصبي المركزي، الذين يؤكد فيهم الفحص الجزيئي غياب طفرة IDH (غير الطافرة لـ IDH). يُعدّ هذا الاكتشاف الجزيئي عاملاً محورياً في تحديد نهج العلاج لهذه الفئة من المرضى.
تفاصيل البروتوكول الكاملة — جميع المكونات والتسلسل ومعايير الأهلية — متاحة عبر الخطة العلاجية المنظمة أدناه.
DOI: 10.1093/neuonc/noab279
People with astrocytomas, IDH-wildtype, CNS WHO grade 2 or 3 may be treated according to recommendations for glioblastoma, IDH-wildtype, CNS WHO grade 4 found in this guideline (Type: informal consensus; Evidence quality: very low; Strength of recommendation: weak).
Concurrent TMZ and RT should be offered to people with newly diagnosed glioblastoma, IDH-wildtype, CNS WHO grade 4 (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: strong).
Six months of adjuvant TMZ should be offered to people with newly diagnosed glioblastoma, IDH-wildtype, CNS WHO grade 4 who have received concurrent RT plus TMZ (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: strong).
Alternating electric field therapy may be added to adjuvant TMZ in people with newly diagnosed supratentorial glioblastoma, IDH-wildtype, CNS WHO grade 4 who have completed chemoradiation therapy (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: weak).
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