Darlix Amélie, Mandonnet Emmanuel, Freyschlag Christian F, Pinggera Daniel, Forster Marie-Therese, Voss Martin, Steinbach Joachim, Loughrey Carmel, Goodden John, Banna Giuseppe, Di Blasi Concetta, Foroglou Nicolas, Hottinger Andreas F, Baron Marie-Hélène, Pallud Johan, Duffau Hugues, Rutten Geert-Jan, Almairac Fabien, Fontaine Denys, Taillandier Luc, Pessanha Viegas Catarina, Albuquerque Luisa, von Campe Gord, Urbanic-Purkart Tadeja, Blonski Marie
Department of Medical Oncology, Institut du Cancer de Montpellier, University of Montpellier, France.
Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France.
Neurooncol Pract. 2019 Jul;6(4):264-273. doi: 10.1093/nop/npy051. Epub 2018 Dec 13.
Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line treatment, the timing and choice of further treatments (chemotherapy, radiation therapy, or combined treatments) remain controversial.
An online survey on the management of DLGG patients was sent to 28 expert centers from the European Low-Grade Glioma Network (ELGGN) in May 2015. It contained 40 specific questions addressing the modalities of use of chemotherapy in these patients.
The survey demonstrated a significant heterogeneity in practice regarding the initial management of DLGG patients and the use of chemotherapy. Interestingly, radiation therapy combined with the procarbazine, CCNU (lomustine), and vincristine regimen has not imposed itself as the gold-standard treatment after surgery, despite the results of the Radiation Therapy Oncology Group 9802 study. Temozolomide is largely used as first-line treatment after surgical resection for high-risk DLGG patients, or at progression.
The heterogeneity in the management of patients with DLGG demonstrates that many questions regarding the postoperative strategy and the use of chemotherapy remain unanswered. Our survey reveals a high recruitment potential within the ELGGN for retrospective or prospective studies to generate new data regarding these issues.
弥漫性低级别胶质瘤（DLGGs）是罕见且无法治愈的肿瘤。虽然基于功能的最大安全手术切除是一线治疗方法，但进一步治疗（化疗、放疗或联合治疗）的时机和选择仍存在争议。
2015年5月，一项关于DLGG患者管理的在线调查被发送至欧洲低级别胶质瘤网络（ELGGN）的28个专家中心。该调查包含40个关于这些患者化疗使用方式的具体问题。
该调查表明，在DLGG患者的初始管理和化疗使用方面，实际操作存在显著异质性。有趣的是，尽管放射治疗肿瘤学组9802研究有相关结果，但放疗联合丙卡巴肼、洛莫司汀（CCNU）和长春新碱方案并未成为术后的金标准治疗方案。替莫唑胺在很大程度上被用作高危DLGG患者手术切除后的一线治疗，或在疾病进展时使用。
DLGG患者管理的异质性表明，许多关于术后策略和化疗使用的问题仍未得到解答。我们的调查显示，ELGGN内有很大的招募潜力用于回顾性或前瞻性研究，以生成有关这些问题的新数据。
