Combined treatment of adult patients with newly diagnosed low-grade gliomas

Low-grade gliomas (LGG, WHO Grade II) are tumors of neuroepithelial origin, accounting for 15 to 45% of all primary brain tumors. According to H.Ohgaki and P. Kleihues (2005), the average time for the progression from glioma to glioblastoma is 5.3 years, and from WHO Gr III to glioblastoma — 1.4 years. The median overall survival for LGG is 186 months, the 5-year overall survival varies from 54.6 to 88.4%, and the relapse-free 5-year survival rate is 37 — 55%; The 8-year relapse-free survival rate is 37%, and the 10-year overall survival rate is 67.1%. The life expectancy of patients with newly diagnosed gliomas averages from 6 to 8 years, but can reach, according to some studies, 20 years. In 80% of cases, symptomatic epilepsy develops in patients with LGG, significantly reducing quality of life. Due to the need for the most radical removal of the tumor with the capture of the epileptic zone, taking into account the diffuse growth and the lack of clear tumor boundaries, as well as frequent localization in functionally significant areas, many surgeons recommend the use of intraoperative electrocorticography and neurophysiological monitoring. Radiation therapy is an important treatment stage after surgical removal of the tumor. The best results of relapse-free survival of patients (5.3 years) were in the group of patients who underwent early postoperative radiation therapy, in contrast to the group where radiation therapy was not performed (3.4 years); overall survival in both groups was not statistically different. According to research data, the use of high radiation doses (> 45–50 Gy) did not improve the prognosis, while the risk of long-term toxicity increased. The recommended dose for the treatment of newly diagnosed STN in adults may be in the range of 45–50.4 Gy.

Key words: low-grade gliomas, diffuse astrocytomas, WHO Grade 2 gliomas, low-grade gliomas radiation therapy, WHO Grade 2 radiation gliomas, WHO Grade 2 radiation therapy of diffuse astrocytes, surgical treatment of diffuse astrocytomas, surgical treatment of gliomas

The authors declare no conflict of interest. Source of financing: not specified.

For citation: Golanov A.V., Banov S.M., Tushev A.A., Moldovanov V.A., Bekyashev A.Kh. Combined treatment of adult patients with newly diagnosed low-grade gliomas. Голова и шея Head and neck Russian Journal. 2018;6(3):48–53 (in Russian).

 The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.