Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network
Abstract Background 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. Meth...
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| Published in | Neuro-oncology practice Vol. 6; no. 4; pp. 264 - 273 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
US
Oxford University Press
27.07.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2054-2577 2054-2585 |
| DOI | 10.1093/nop/npy051 |
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| Abstract | Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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. |
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| AbstractList | Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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. BACKGROUND: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.METHODS: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.RESULTS: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.CONCLUSIONS: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. 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.BACKGROUNDDiffuse 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.METHODSAn 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.RESULTSThe 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.CONCLUSIONSThe 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. 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. |
| Author | Baron, Marie-Hélène Steinbach, Joachim Banna, Giuseppe Almairac, Fabien Mandonnet, Emmanuel Fontaine, Denys Pallud, Johan Freyschlag, Christian F Forster, Marie-Therese Goodden, John Duffau, Hugues Hottinger, Andreas F Foroglou, Nicolas Albuquerque, Luisa Darlix, Amélie Pinggera, Daniel Loughrey, Carmel Di Blasi, Concetta Blonski, Marie von Campe, Gord Pessanha Viegas, Catarina Voss, Martin Rutten, Geert-Jan Taillandier, Luc Urbanic-Purkart, Tadeja |
| AuthorAffiliation | 3 Department of Neurosurgery, Medical University of Innsbruck, Austria 14 Department of Neurosurgery, Montpellier University Hospital, France 7 Leeds General Infirmary and North East Paediatric Neuroscience Network, Leeds, United Kingdom 16 Department of Neurosurgery, University Hospital of Nice, France 4 Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany 18 Hospital Garcia de Orta, Almada, Portugal 17 Department of Neurooncology, Nancy Neurological Hospital, France 5 Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany 15 Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands 13 Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France 1 Department of Medical Oncology, Institut du Cancer de Montpellier, University of Montpellier, France 8 Department of Neurosurgery and Gammaknife, Cannizzaro General Hospital, Catania, Italy 11 Department of Radiotherapy, Besançon University Hospital, Fr |
| AuthorAffiliation_xml | – name: 2 Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France – name: 3 Department of Neurosurgery, Medical University of Innsbruck, Austria – name: 13 Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France – name: 17 Department of Neurooncology, Nancy Neurological Hospital, France – name: 1 Department of Medical Oncology, Institut du Cancer de Montpellier, University of Montpellier, France – name: 16 Department of Neurosurgery, University Hospital of Nice, France – name: 7 Leeds General Infirmary and North East Paediatric Neuroscience Network, Leeds, United Kingdom – name: 14 Department of Neurosurgery, Montpellier University Hospital, France – name: 10 Departments of Clinical Neurosciences and Oncology, Centre Hospitalier Universitaire Vaudois and Lausanne University, Switzerland – name: 5 Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany – name: 19 Department of Neurosurgery, Medical University of Graz, Austria – name: 12 Department of Neurosurgery, Sainte-Anne Hospital, Paris, France, and Paris Descartes University, Sorbonne Paris Cité, France – name: 6 Leeds General Infirmary, United Kingdom – name: 11 Department of Radiotherapy, Besançon University Hospital, France – name: 18 Hospital Garcia de Orta, Almada, Portugal – name: 15 Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands – name: 8 Department of Neurosurgery and Gammaknife, Cannizzaro General Hospital, Catania, Italy – name: 4 Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany – name: 9 Aristotle University of Thessaloniki, Department of Neurosurgery, AHEPA University Hospital, Greece |
| Author_xml | – sequence: 1 givenname: Amélie surname: Darlix fullname: Darlix, Amélie email: amelie.darlix@icm.unicancer.fr organization: Department of Medical Oncology, Institut du Cancer de Montpellier, University of Montpellier, France – sequence: 2 givenname: Emmanuel surname: Mandonnet fullname: Mandonnet, Emmanuel organization: Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France – sequence: 3 givenname: Christian F surname: Freyschlag fullname: Freyschlag, Christian F organization: Department of Neurosurgery, Medical University of Innsbruck, Austria – sequence: 4 givenname: Daniel surname: Pinggera fullname: Pinggera, Daniel organization: Department of Neurosurgery, Medical University of Innsbruck, Austria – sequence: 5 givenname: Marie-Therese surname: Forster fullname: Forster, Marie-Therese organization: Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany – sequence: 6 givenname: Martin surname: Voss fullname: Voss, Martin organization: Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany – sequence: 7 givenname: Joachim surname: Steinbach fullname: Steinbach, Joachim organization: Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany – sequence: 8 givenname: Carmel surname: Loughrey fullname: Loughrey, Carmel organization: Leeds General Infirmary, United Kingdom – sequence: 9 givenname: John surname: Goodden fullname: Goodden, John organization: Leeds General Infirmary and North East Paediatric Neuroscience Network, Leeds, United Kingdom – sequence: 10 givenname: Giuseppe surname: Banna fullname: Banna, Giuseppe organization: Department of Neurosurgery and Gammaknife, Cannizzaro General Hospital, Catania, Italy – sequence: 11 givenname: Concetta surname: Di Blasi fullname: Di Blasi, Concetta organization: Department of Neurosurgery and Gammaknife, Cannizzaro General Hospital, Catania, Italy – sequence: 12 givenname: Nicolas surname: Foroglou fullname: Foroglou, Nicolas organization: Aristotle University of Thessaloniki, Department of Neurosurgery, AHEPA University Hospital, Greece – sequence: 13 givenname: Andreas F surname: Hottinger fullname: Hottinger, Andreas F organization: Departments of Clinical Neurosciences and Oncology, Centre Hospitalier Universitaire Vaudois and Lausanne University, Switzerland – sequence: 14 givenname: Marie-Hélène surname: Baron fullname: Baron, Marie-Hélène organization: Department of Radiotherapy, Besançon University Hospital, France – sequence: 15 givenname: Johan orcidid: 0000-0002-1652-9844 surname: Pallud fullname: Pallud, Johan organization: Department of Neurosurgery, Sainte-Anne Hospital, Paris, France, and Paris Descartes University, Sorbonne Paris Cité, France – sequence: 16 givenname: Hugues surname: Duffau fullname: Duffau, Hugues organization: Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France – sequence: 17 givenname: Geert-Jan surname: Rutten fullname: Rutten, Geert-Jan organization: Department of Neurosurgery, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands – sequence: 18 givenname: Fabien surname: Almairac fullname: Almairac, Fabien organization: Department of Neurosurgery, University Hospital of Nice, France – sequence: 19 givenname: Denys surname: Fontaine fullname: Fontaine, Denys organization: Department of Neurosurgery, University Hospital of Nice, France – sequence: 20 givenname: Luc surname: Taillandier fullname: Taillandier, Luc organization: Department of Neurooncology, Nancy Neurological Hospital, France – sequence: 21 givenname: Catarina surname: Pessanha Viegas fullname: Pessanha Viegas, Catarina organization: Hospital Garcia de Orta, Almada, Portugal – sequence: 22 givenname: Luisa surname: Albuquerque fullname: Albuquerque, Luisa organization: Hospital Garcia de Orta, Almada, Portugal – sequence: 23 givenname: Gord surname: von Campe fullname: von Campe, Gord organization: Department of Neurosurgery, Medical University of Graz, Austria – sequence: 24 givenname: Tadeja surname: Urbanic-Purkart fullname: Urbanic-Purkart, Tadeja organization: Department of Neurosurgery, Medical University of Graz, Austria – sequence: 25 givenname: Marie surname: Blonski fullname: Blonski, Marie organization: Department of Neurooncology, Nancy Neurological Hospital, France |
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Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the... Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line treatment, the... BACKGROUND:Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line... |
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| Title | Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network |
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