Anaplastic astrocytomas (World Health Organization grade III) have a low cure rate with standard local treatment. [1] Patients with anaplastic astrocytomas are appropriate candidates for clinical trials designed to improve local control by adding newer forms of treatment to standard treatment. (Refer to the Anaplastic Astrocytoma section in the Classification section of this summary for more information.)

Standard treatment options:

1. Surgery plus radiation therapy.
2. Surgery plus radiation therapy and chemotherapy as seen in the NCOG-6G61trial, for example. [2] [3] [4] [5] [6] [7]

Treatment options under clinical evaluation:

• Patients with brain tumors that are either infrequently curable or unresectable should be considered candidates for clinical trials that evaluate hyperfractionated radiation therapy, accelerated-fraction radiation, stereotactic radiosurgery, radiosensitizers, hyperthermia, interstitial brachytherapy, or intraoperative radiation therapy used in conjunction with external-beam radiation therapy (EBRT) to improve local control of the tumor. Such patients are also candidates for studies that evaluate new drugs and biological response modifiers following radiation therapy. [8] [9] [10] [11] [12] Cooperative group trials that evaluate chemoradiation therapy administered with either hyperfractionated radiation therapy or a combination of brachytherapy and EBRT are now in progress.
• Carmustine (BCNU)-impregnated polymer may be implanted during surgery. [13] [14]