Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide

Summary

Carmustine implants are recommended as a possible treatment for people with newly diagnosed high-grade glioma only if 90% or more of their tumour has been removed. People should have carmustine implants only at specialist treatment centres under the care of a team of experts, as described in ‘Improving outcomes for people with brain and other central nervous system tumours’ (NICE cancer service guidance 2006; www.nice.org.uk/csgbraincns). Treatment should be supervised by specialist neurosurgeons who:

• spend at least half of their time working in surgery to treat cancers of the brain and spinal cord
• work with a team of other specialists and have access to magnetic resonance imaging (MRI) to help predict before the operation whether it will be possible to remove 90% of the person’s tumour
• have access to technology that helps them precisely locate the tumour during the operation.

Carmustine implants are not recommended for people with newly diagnosed high-grade glioma if less than 90% of their tumour has been removed.

Temozolomide is recommended as a possible treatment for people with newly diagnosed glioblastoma multiforme (a type of high-grade glioma) who have a World Health Organization (WHO) performance status of 0 (they are able to carry out all normal activity without restriction) or 1 (they are restricted in strenuous activity but are able to move around and carry out light work).

Documents

For healthcare professionals

• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Quick reference guide
• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Guidance (MS Word format)
• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Guidance

For patients, carers and the public

• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Understanding NICE guidance (MS Word format)
• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Understanding NICE guidance

Background information

• 2007/034 NICE issues guidance on the use of carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Audit criteria
• TA121 Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Costing template