Carmustine implants and temozolomide for the treatment of newly diagnosed high grade glioma

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).

• Other information

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

  How this guidance was produced

  Background information

  • Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: review proposal - August 2010
  • NICE issues guidance on the use of carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma
  • Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide: Review Decision - October 2010
  • Appendix A: Decision paper considered by the Institute's Guidance Executive

Guidance formats

• Web format
• Quick reference guide (PDF)
• Full Guidance (PDF)
• Patient version (MS Word)
• TA121 Mewnblaniadau carmustine a temozolomide ar gyfer trin glioma uchelradd sydd newydd ei ganfod: deall canllawiau NICE (fformat MS Word)

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

Guideline for patients and carers (PDF)