REVIEW   

Journal of Neurosurgical Sciences 2019 August;63(4):450-7

DOI: 10.23736/S0390-5616.19.04701-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The management of low-grade gliomas in adults

Ramin A. MORSHED, Jacob S. YOUNG, Shawn L. HERVEY-JUMPER, Mitchel S. BERGER ✉

Department of Neurological Surgery, University of California, San Francisco, CA, USA

Low grade gliomas (LGGs) are WHO grade II tumors that affect mostly adult patients and include diffuse astrocytomas and oligodendrogliomas. New diagnostic criteria based on histology and molecular characterization with IDH mutation status and 1p/19q codeletion status have provided further categorization of these tumors and additional insights into prognosis and treatment response. In general, the current management of LGG favors maximum upfront resection with consideration of combined chemoradiation for patients deemed “high risk.” In this review, we summarize the defining molecular features, important prognostic factors, recommended pre-operative imaging work-up, as well as therapeutic management of WHO Grade II low grade gliomas in adults.

KEY WORDS: Glioma; Radiotherapy; Drug therapy; Temozolomide; Vincristine; Procarbazine