gms | German Medical Science

Low grade gliomas are slow-growing tumours. However, the clinical course can be quite inhomogenous. The present retrospective analysis was performed to evaluate prognostic factors and the influence of various therapeutic procedures on the outcome.

130 Patients with histologically confirmed WHO grade II glioma were treated in our institution between 1985-2002. The patients' charts were reviewed retrospectively with regard to patient characteristics including age, gender, Karnofsky performance status and family history. The minimum follow-up time was 24 months. With regard to the tumour, histology, size and localisation were documented. Various therapy alternatives such as the extent of surgery in combination with radiotherapy (RT) and chemotherapy (CH) as well as the time point of radiotherapy were analysed.

Mean age at primary diagnosis was 36.9 years (8-70years), M:F=3:2. 8/130 (6.1%) patients had a family history of brain tumours. Histological diagnosis was oligoastrocytoma in 25.5%, oligodendroglioma in 27.7% and astrocytoma in 40.8%. The most common localisation was the frontal lobe (46.2%). 187 neurosurgical interventions were performed in this patient collective. A subtotal resection was performed in 27.8%. 53% of all Patients received RT. In 56.2% of them, adjuvant RT was applied at primary diagnosis, in 38.4% RT was performed later in the time course or at tumour progression. Re-RT was performed in 5.4%. The analysis of progression free and overall survival (PFS, OS) revealed the extent of neurosurgical resection as a prognostic factor. Patients treated with RT after subtotal resection showed no significant survival benefit compared to patients treated with surgery only.

Our results are in accordance with literature, however, the patients treated with RT at primary diagnosis are likely to be a highly selected patient collective. Further evaluation is warranted to evaluate selection criteria.