Oligoastrocytoma secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and corticosteroid use (Macdonald criteria), routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment. Secondary prevention measures of nasopharyneal cancer include routine physical examination and imaging at scheduled intervals after treatment. Dental screening and screening for thyroid cancers are recommended among patients who had received radiation therapy to the oral cavity and cervical region, respectively.

Secondary Prevention

Follow up after treatment

Patients treated for oligoastrocytoma should follow-up for secondary prevention. Follow-up measures are shown in the table below:

• Clinical assessment of neurological function

• Tapering steroid usage as early as possible
• Checking for signs of venous thromboembolism
• Laboratory tests
  • Generally not indicated, unless patient is on chemotherapy (complete blood count), steroids (glucose level), and anticonvulsants (complete blood count and liver function tests)
• MRI every 3-4 months
• Positron emission tomography
  • To differentiate tumor recurrence from radiation-induced tumor necrosis

Follow up	Description
Clinical assessment of neurological function
Nasendoscopy	Immediately following radiation therapy
Scanning CT Scan MRI	Scans are performed at routine intervals as follows: Baseline scanning is performed at 3-6 months after treatment, further scans are scheduled based on finding of physical exam and symptoms experienced by the patient Scanning for asymptomatic patients is not recommended
Thyroid hormone testing	Thyroid stimulating hormone testing every 12 months if the neck was exposed to radiation
Dental screening	Only recommended if oral cavity was exposed to radiation

^{Table adapted from Pfister DG, et al. Head and neck cancers, version 2.2013. Featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2013;11(8):917-23.}

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