Gliomas de bajo grado: viejas controversias, nuevas evidencias / Low grade glioma: old controversies, new evidences

RESUMO

Many aspects of the management of low-grade gliomas have been controversial. Warren Mason reviews the new evidence addressing some of them in the article Advances in the management of low-grade gliomas, published in Can J. Neurol. Sci. 2005. This information should be specially useful for tailoring therapies to each particular situation. The presence of an oligodendroglial component and 1p and 19q deletions confers a better prognosis and better response rates to chemotherapy and radiotherapy. Delaying interventions in stable, asymptomatic patients does not seem to affect overall survival. More extensive resections are associated to longer and better quality survival. Early radiotherapy prolongs time to progression, but not overall survival as compared to delayed radiotherapy. The optimal dose is in the range between 45Gy and less than 59.4 Gy. Chemotherapy produces responses in most of these patients.