Article
Contemporary management of diffuse low-grade glioma from six certified neuro-oncological centres – prospective data from the LoG-Glio registry
Aktuelle Behandlung von diffusen niedergradigen Gliomen in sechs zertifizierten neuro-onkologischen Zentren – prospektive Daten aus dem LoG-Glio Register
Search Medline for
Authors
-
Jan Coburger
- Universität Ulm, Neurochirurgie, Günzburg, Deutschland
-
Minou Nadji-Ohl
- Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
-
Christian von der Brelie
- Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
-
Stefan Rückriegel
- Julius-Maximilians-Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
-
Constantin Roder
- Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
-
Katharina Faust
- Charité – Universitätsmedizin Berlin, Neurochirurgie, Berlin, Deutschland
-
Daniel Sachs
- Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
-
Sonja Grüninger
- Universität Ulm, Neurochirurgie, Günzburg, Deutschland
-
Mario Löhr
- Julius-Maximilians-Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
-
Peter Vajkoczy
- Charité – Universitätsmedizin Berlin, Neurochirurgie, Berlin, Deutschland
-
Marcos Tatagiba
- Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
-
Ralf-Ingo Ernestus
- Julius-Maximilians-Universität Würzburg, Neurochirurgie, Würzburg, Deutschland
-
Veit Rohde
- Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
-
Oliver Ganslandt
- Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
-
Christian Rainer Wirtz
- Universität Ulm, Neurochirurgie, Günzburg, Deutschland
-
Andrej Pala
- Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland
| Published: | June 26, 2020 |
|---|
Outline
Text
Objective: In recent years, some level of consensus for management of diffuse astrocytoma and oligodendroglioma was reached. Aim of the present study was to assess the current management of these lesions based on data from the LoG-Glio registry.
Methods: Prospective data sets of primary diagnosis of WHO°II/III astrocytoma or oligodendroglioma registered from 2016 to 2019 in 6 certified neuro-oncological centers were retrieved and analyzed for type and timing of surgical treatment and planed adjuvant treatment. A descriptive assessment was performed.
Results: 76 patients with histologically confirmed diagnosis were retrieved. 43 astrocytoma (74% WHO°II) and 33 oligodendroglioma (91% WHO°II) were found. 65 patients (78%) had surgery within 3 months after primary diagnosis (PD). Maximum time from PD to surgery was 5.6a. Open surgery was performed in 67 patients (87%), while stereotactic biopsy was done in 10 (13%).
Planned adjuvant treatment in IDH mutated astrocytoma with residual tumor(19) was "wait-and-scan" in 3 patients (16%), radiotherapy (RT) in 5 patients (26%), combined RT/temozolomid (TMZ) in 8 patients(42%), consecutive RT/TMZ in 2 patient (11%) and consecutive PCV in 1 patient (65). IDH mutated astrocytoma without (w/o) residual tumor (11) were treated with "wait-and-scan" in 7 pts (63%), RT in 1 pts (9%) and combined RT/TMZ in 3 pts (27%).
IDH wildtype astrocytoma (14) where treated with combined RT/TMZ in 11 pts (79%). All others received "wait-and-scan".
Oligodendroglioma with residual tumor (16) had "wait-and-scan" in 1 pt (6%), RT in 6 (35%) PCV in 3 pts (18%), combined RT/TMZ in 3 pts (18%); and consecutive RT/PCV in 4 (24%). W/o residual tumor (17) had "wait-and-scan" in 11 pts. (69%), combined RT/TMZ in 1 (6%) and consecutive RT/TMZ in 1 pt and consecutive RT/PCV in 3 pts (19%).
Conclusion: While early surgical treatment was performed in the majority of cases, adjuvant treatment of low grade glioma remained largely heterogeneous in this contemporary cohort of patients treated in certified neurooncological centers. Especially, patients with oligodendroglioma and residual tumor where treated with consecutive RT and PC(V) only in ¼ of cases despite results of RTOG 9802. Hence an early update of the current glioma guidelines is recommended.
