Cancer Guidelines Database

This is a clinical practice guideline for patients with central nervous system cancers. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Surgical options, adjuvant therapy, and postoperative staging are specifically considered.

This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.

This is a clinical practice guideline for adult patients with neuroendocrine tumours. The guideline examines diagnosis using histological markers and imaging, management of tumours through appropriate treatment strategies, and appropriate time periods for follow-up. Recommendations are presented for both non-pancreatic and pancreatic neuroendocrine tumours. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.

This clinical practice guideline is an endorsement of two 2019 guidelines published by the Congress of Neurological Surgeons on the use of anticonvulsant prophylaxis and steroids in adults with metastatic brain tumours. Specific topics addressed include the choice of steroid, steroid dose and duration of administration, and primary outcomes of interest were decreases in frequency of seizures, as well as increases in quality of life and survival.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline focuses on non-standard or 'emerging' techniques for the treatment of these patients. Outcomes of interest include local response, progression-free survival, and local recurrence.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the impact of steroids on neurological symptoms and/or quality of life in these patients, compared to supportive care alone or other treatment options. The choice of steroid, steroid dose and duration of administration are also discussed. Recommendations provided are stratified by severity of symptoms related to mass effect.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines treatment options specifically for patients with multiple metastatic brain tumours. Treatment options discussed include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS).

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline discusses the use of chemotherapy for the treatment of these patients, and examines the use of chemotherapy alone, chemotherapy in addition to whole brain radiation therapy (WBRT), and chemotherapy in addition to stereotactic radiosurgery (SRS). The sequence of treatments and number of chemotherapeutic regimens are also considered.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the use of stereotactic radiosurgery for the treatment of these patients. Stereotactic radiosurgery (SRS) is compared with other treatment modalities, and the guideline also discussed the role of SRS after open surgical resection of brain metastasis, and the role of SRS alone for the management of patients with one to four brain metastases.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline provides recommendations on the surgical management of these patients. Surgery alone, surgery with stereotactic radiosurgery (SRS), and surgery with whole brain radiation therapy (WBRT) are all discussed.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the role of prophylactic anticonvulsants during the treatment of these patients. Reducing the number of seizures experienced by these patients is the primary outcome of interest.

This clinical practice guideline is part of a series of guidelines for the management of adult patients with newly diagnosed metastatic brain tumours, excluding radiosensitive tumour histologies. The guideline examines the role of whole brain radiation therapy (WBRT) for the treatment of these patients. Topics of interest include optimal dose/fractionation schedule, the impact tumour histopathology or molecular status has on the decision to use WBRT, and the dose fractionation scheme utilized.

This is a clinical practice guideline for patients with central nervous system cancers. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Surgical options, adjuvant therapy, and postoperative staging are specifically considered.

This is an organizational guideline for adult patients with brain metastases who are eligible to receive stereotactic radiosurgery (SRS) in Ontario. Topics of discussion include qualifications for the practice team, the determination of patient eligibility, appropriate technologies for the delivery of SRS, as well as pre- and post-intervention imaging.

This is a clinical practice guideline for patients with brain tumours. The guideline provides recommendations for the management of brain tumour-related epilepsy (BTE) in these patients. Specifically, the guideline provides recommendations for the diagnosis and treatment of BTE, including which anti-epileptic medications should be used.

This is a clinical practice guideline for patients aged 16 or older who have primary brain tumours or brain metastases. Specifically, the guideline examines the diagnoses and management of radiologically identified glioma, meningioma, and brain metastases. Follow-up care after treatment and supportive care are also discussed, and additional recommendations are provided on the referral of adults with primary brain tumours or brain metastases for neurological rehabilitation assessment.

This is a clinical practice guideline for adult and pediatric patients with suspected or diagnosed well-differentiated neuroendocrine tumours (NETs). The guideline discusses the clinical utility of Gallium-68 positron emission tomography (PET) compared with PET / computed tomography imaging for the initial diagnosis, staging, re-staging, response evaluation, and routine surveillance of patients with NETs.

This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

This is a clinical practice guideline for patients with aggressive pituitary tumours and carcinomas, which provides recommendations on diagnosis, treatment, and follow-up. Treatment options such as surgery, radiotherapy, and temozolomide are examined. Further guidance on dosing regimens, adverse effects, discontinuation, and combination chemotherapies is provided for temozolomide. Recurrence, non-responders, and systemic metastasis are also discussed.

This is a clinical practice guideline for patients with neuroendocrine or adrenal tumours. The guideline discusses the diagnosis, staging, treatment, and follow-up of patients with sporadic neuroendocrine tumours, originating from organs such as the lungs, thymus, and gastrointestinal (GI) tract. The guideline also examines the role of the genetic syndrome, multiple endocrine neoplasia (MEN), in developing parathyroid, pituitary, and pancreatic tumours.

This is a clinical practice guideline for adults with benign brain tumors. The guideline examines the appropriateness of stereotactic radiosurgery for treating these patients, as well as the appropriate dose for stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). Recommendations are provided for benign brain tumors that can be treated with stereotactic radiotherapy, including vestibular schwannoma, pituitary adenomas, meningiomas, and other indications such as craniopharyngiomas and hemangioblastomas.

This is a clinical guideline for the treatment of primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL). The guideline provides recommendations regarding chemotherapy and radiation therapy and the optimal regimens, radiation dose and schedule. Outcomes of interest include overall survival, measure of disease control (response rates and progression-free survival), and frequency of adverse events.

This is a clinical practice guideline for the diagnosis, treatment and follow-up of adult patients with anaplastic gliomas. The guideline provides a diagnostic algorithm for anaplastic gliomas that considers isocitrate dehydrogenase 1/2 (IDH1/IDH2) missense mutations and 1p/19q co-deletions. Topics of discussion include radiology, histology and molecular biology, prognostic factors, surgery, radiotherapy, options for first-line systemic treatment, support treatment (e.g., corticoids and anticonvulsants), and follow-up.

This is a clinical practice guideline for children and adults with ependymal tumours. The guideline provides recommendations for the diagnosis, staging, treatment and follow-up of these patients. Radiological, histological, and molecular components of diagnostic assessment are discussed, and treatment approaches involving surgery and radiation therapy are examined.

This is a clinical practice guideline for patients with leptomeningeal metastases from solid tumours. The guideline discusses the diagnosis, treatment, and follow-up of these patients, and a treatment algorithm is presented based on life expectancy. Treatment options examined include systemic pharmacotherapy, intra-cerebrospinal fluid pharmacotherapy, focal radiotherapy (RT), and whole brain radiotherapy (WBRT).

This a clinical practice guideline on the use of radiosurgery for the treatment of patients with central nervous system (CNS) metastatic tumours. Treatment efficacy, safety, toxicity are specifically discussed. The guideline also considers the benefits and disadvantages of performing two treatment modalities involving radiosurgery, as well as the role adjuvant radiosurgery.

This is a clinical practice guideline for adult patients with four or fewer brain metastases. The guideline examines the important prognostic factors for assessing and managing these patients, the role of surgery and radiotherapy in the management of oligometastatic disease, and the appropriate follow-up and surveillance strategy. Treatments considered include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), both alone and in conjunction.

This is a clinical practice guideline for adults with low-grade gliomas (LGG), including oligodendrogliomas and astrocytomas. The guideline provides recommendations for the diagnosis, management and follow-up of these patients. Radiological evaluation, surgical options, and the use and timing of complementary treatment (i.e. adjuvant chemotherapy and radiation therapy) after surgery are specifically discussed.

This is a clinical practice guideline for patients who have been operated on for a pheochromocytoma or a paraganglioma. The guideline discusses the long-term follow-up of these patients, and includes recommendations on diagnosing malignancy, perioperative work-up, duration of follow-up, monitoring methods, as well as specific considerations for pregnant women and patients who are frail and/or elderly.

This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.

This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.

This is a clinical practice guideline for adults with diffuse gliomas. Diagnosis, as well as treatment methods including chemotherapy, radiation therapy, and surgical procedures are discussed. The guideline provides general recommendations, as well as specific recommendations for low grade gliomas (WHO grade II), anaplastic gliomas (WHO grade III), and glioblastoma (WHO grade IV).

This is a clinical practice guideline for adults with low-grade gliomas (LGGs). The guideline examines the diagnosis, prognosis, and treatment of these patients. Treatment modalities discussed include surgery, radiation therapy, and chemotherapy.

This is a clinical practice guideline for patients with meningiomas. Recommendations are provided regarding diagnosis, including radiological methods used, collection and storage of tissue, and histological verification. Different treatment and follow-up recommendations are also discussed, based on which World Health Organization (WHO) grade the meningioma is classified as (i.e. WHO grades I-III).

This clinical practice guideline is an endorsement of the American Society for Radiation Oncology's 2016 guideline on radiation therapy (RT) for glioblastoma not originating from the brainstem. This guideline provides recommendations on whether and how RT should be applied, and examines dose-fractionation, target volume design, and the effects of concurrent and adjuvant systemic therapies. Outcomes included overall and progression-free survival, recurrence rates, toxicity, and quality of life (QOL).

This is a clinical practice guideline for patients with glioblastoma. The guideline examines radiation therapy as treatment for these patients, and the ways in which systemic therapies modify its effects. The guideline also reviews ideal dose-fractionation, target volume design, and reirradiation for recurrent glioblastoma. Tumour-specific and patient-specific factors are considered in the recommendations.