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Neurooncol Pract. 2019 Jul;6(4):264-273. doi: 10.1093/nop/npy051. Epub 2018 Dec 13.

Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network.

Author information

1
Department of Medical Oncology, Institut du Cancer de Montpellier, University of Montpellier, France.
2
Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France.
3
Department of Neurosurgery, Medical University of Innsbruck, Austria.
4
Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany.
5
Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany.
6
Leeds General Infirmary, United Kingdom.
7
Leeds General Infirmary and North East Paediatric Neuroscience Network, Leeds, United Kingdom.
8
Department of Neurosurgery and Gammaknife, Cannizzaro General Hospital, Catania, Italy.
9
Aristotle University of Thessaloniki, Department of Neurosurgery, AHEPA University Hospital, Greece.
10
Departments of Clinical Neurosciences and Oncology, Centre Hospitalier Universitaire Vaudois and Lausanne University, Switzerland.
11
Department of Radiotherapy, Besançon University Hospital, France.
12
Department of Neurosurgery, Sainte-Anne Hospital, Paris, France, and Paris Descartes University, Sorbonne Paris Cité, France.
13
Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France.
14
Department of Neurosurgery, Montpellier University Hospital, France.
15
Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
16
Department of Neurosurgery, University Hospital of Nice, France.
17
Department of Neurooncology, Nancy Neurological Hospital, France.
18
Hospital Garcia de Orta, Almada, Portugal.
19
Department of Neurosurgery, Medical University of Graz, Austria.

Abstract

Background:

Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line treatment, the timing and choice of further treatments (chemotherapy, radiation therapy, or combined treatments) remain controversial.

Methods:

An online survey on the management of DLGG patients was sent to 28 expert centers from the European Low-Grade Glioma Network (ELGGN) in May 2015. It contained 40 specific questions addressing the modalities of use of chemotherapy in these patients.

Results:

The survey demonstrated a significant heterogeneity in practice regarding the initial management of DLGG patients and the use of chemotherapy. Interestingly, radiation therapy combined with the procarbazine, CCNU (lomustine), and vincristine regimen has not imposed itself as the gold-standard treatment after surgery, despite the results of the Radiation Therapy Oncology Group 9802 study. Temozolomide is largely used as first-line treatment after surgical resection for high-risk DLGG patients, or at progression.

Conclusions:

The heterogeneity in the management of patients with DLGG demonstrates that many questions regarding the postoperative strategy and the use of chemotherapy remain unanswered. Our survey reveals a high recruitment potential within the ELGGN for retrospective or prospective studies to generate new data regarding these issues.

KEYWORDS:

PCV; chemotherapy; clinical practice; diffuse low-grade glioma; temozolomide

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