Current View on Management of Central Nervous System Low-grade Gliomas

Česká verzia

Authors: J. Polívka Jr ^1,2; J. Polívka ³; V. Rohan ³; V. Přibáň ⁴
Authors place of work: Ústav histologie a embryologie, LF UK v Plzni ¹; Biomedicínské centrum, LF UK v Plzni ²; Neurologická klinika LF UK a FN Plzeň ³; Neurochirurgická klinika LF UK a FN Plzeň ⁴
Published in the journal: Cesk Slov Neurol N 2016; 79/112(5): 534-540
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2016534

Summary

The diagnosis of grade II central nervous system glioma (Low-Grade Glioma; LGG) always significantly impacts on the lives of patients, as, despite clear progress in therapy, LGG continues to be an incurable disease. Treatment options include neurosurgical intervention, radiotherapy and chemotherapy. So far, however, no clear criteria have been set to determine the effect of individual treatments, their combinations or their timing. The results of a long-term follow up of the phase III RTOG 9802 trial demonstrated better effect of combined radiotherapy (54 Gy) and chemotherapy (procarbazine, lomustine and vincristine; PCV) treatment in patients with high risk disease (age > 40 years with postoperative radiographic residuum or age ≥ 40 years after any surgical intervention). The question of the role of molecular genetic biomarkers (co-deletion 1p/19q, IDH1/2 mutations and others) in predicting the effects of combined treatment remains unanswered. It is expected that detailed molecular genetic analysis of each tumor will become a part of routine clinical care of patients with gliomas of all stages of malignancy, including LGG. Combined radiotherapy and chemotherapy with PCV following neurosurgical intervention should be the preferred approach to treatment of patients with high-risk LGG.

Key words:
low-grade glioma – chromosomal codeletion 1p/19q – IDH1/2 mutations – personalized medicine

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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