Abstract
The diagnosis of grade II central nervous system glioma (Low-Grade Glioma; LGG) always signifi cantly 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 eff ect 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 eff ect 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 GREATER-THAN OR EQUAL TO 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 eff ects 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.