Guidelines on management of low-grade gliomas: Report of an EFNS-EANO Task Force

R. Soffietti, B. G. Baumert, L. Bello, A. Von Deimling, H. Duffau, M. Frénay, W. Grisold, R. Grant, F. Graus, K. Hoang-Xuan, M. Klein, B. Melin, J. Rees, T. Siegal, A. Smits, R. Stupp, W. Wick

Research output: Contribution to journalArticle

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Abstract

Background: Diffuse infiltrative low-grade gliomas of the cerebral hemispheres in the adult are a group of tumors with distinct clinical, histological and molecular characteristics, and there are still controversies in management. Methods: The scientific evidence of papers collected from the literature was evaluated and graded according to EFNS guidelines, and recommendations were given accordingly. Results and conclusions: WHO classification recognizes grade II astrocytomas, oligodendrogliomas and oligoastrocytomas. Conventional MRI is used for differential diagnosis, guiding surgery, planning radiotherapy and monitoring treatment response. Advanced imaging techniques can increase the diagnostic accuracy. Younger age, normal neurological examination, oligodendroglial histology and 1p loss are favorable prognostic factors. Prophylactic antiepileptic drugs are not useful, whilst there is no evidence that one drug is better than the others. Totalnear total resection can improve seizure control, progression-free and overall survival, whilst reducing the risk of malignant transformation. Early post-operative radiotherapy improves progression-free but not overall survival. Low doses of radiation are as effective as high doses and better tolerated. Modern radiotherapy techniques reduce the risk of late cognitive deficits. Chemotherapy can be useful both at recurrence after radiotherapy and as initial treatment after surgery to delay the risk of late neurotoxicity from large-field radiotherapy. Neurocognitive deficits are frequent and can be caused by the tumor itself, tumor-related epilepsy, treatments and psychological distress.

Original languageEnglish
Pages (from-to)1124-1133
Number of pages10
JournalEuropean Journal of Neurology
Volume17
Issue number9
DOIs
Publication statusPublished - Sep 2010

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Advisory Committees
Glioma
Radiotherapy
Guidelines
Oligodendroglioma
Neoplasms
Astrocytoma
Neurologic Examination
Cerebrum
Anticonvulsants
Disease-Free Survival
Epilepsy
Histology
Seizures
Differential Diagnosis
Therapeutics
Radiation
Psychology
Recurrence
Drug Therapy

Keywords

  • genetics
  • low-grade gliomas
  • neuroimaging
  • pathology
  • treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Soffietti, R., Baumert, B. G., Bello, L., Von Deimling, A., Duffau, H., Frénay, M., ... Wick, W. (2010). Guidelines on management of low-grade gliomas: Report of an EFNS-EANO Task Force. European Journal of Neurology, 17(9), 1124-1133. https://doi.org/10.1111/j.1468-1331.2010.03151.x

Guidelines on management of low-grade gliomas : Report of an EFNS-EANO Task Force. / Soffietti, R.; Baumert, B. G.; Bello, L.; Von Deimling, A.; Duffau, H.; Frénay, M.; Grisold, W.; Grant, R.; Graus, F.; Hoang-Xuan, K.; Klein, M.; Melin, B.; Rees, J.; Siegal, T.; Smits, A.; Stupp, R.; Wick, W.

In: European Journal of Neurology, Vol. 17, No. 9, 09.2010, p. 1124-1133.

Research output: Contribution to journalArticle

Soffietti, R, Baumert, BG, Bello, L, Von Deimling, A, Duffau, H, Frénay, M, Grisold, W, Grant, R, Graus, F, Hoang-Xuan, K, Klein, M, Melin, B, Rees, J, Siegal, T, Smits, A, Stupp, R & Wick, W 2010, 'Guidelines on management of low-grade gliomas: Report of an EFNS-EANO Task Force', European Journal of Neurology, vol. 17, no. 9, pp. 1124-1133. https://doi.org/10.1111/j.1468-1331.2010.03151.x
Soffietti, R. ; Baumert, B. G. ; Bello, L. ; Von Deimling, A. ; Duffau, H. ; Frénay, M. ; Grisold, W. ; Grant, R. ; Graus, F. ; Hoang-Xuan, K. ; Klein, M. ; Melin, B. ; Rees, J. ; Siegal, T. ; Smits, A. ; Stupp, R. ; Wick, W. / Guidelines on management of low-grade gliomas : Report of an EFNS-EANO Task Force. In: European Journal of Neurology. 2010 ; Vol. 17, No. 9. pp. 1124-1133.
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