Survey on current practice within the European Low-Grade Glioma Network: where do we stand and what is the next step?

Abstract

Diffuse low-grade glioma form a rare entity affecting young people. Despite advances in surgery, chemotherapy, and radiation therapy, diffuse low-grade glioma are still incurable. According to current guidelines, maximum safe resection, when feasible, is the first line of treatment. Apart from surgery, all other treatment modalities (temozolomide, procarbazine-CCNU-vincristine regimen, and radiation therapy) are handled very differently among different teams, and this in spite of recent results of several phase 3 studies. Based on a European survey, this paper aimed to get a picture of this heterogeneity in diffuse low-grade glioma management, to identify clinically relevant questions raised by this heterogeneity of practice, and to propose new methodological frameworks to address these questions.

Keywords: GLIOCOM; diffuse low-grade glioma; evidence-based medicine; surgery; survey.

Figures

Fig. 1

European map of cities hosting centers participating in the survey. The map was adapted from http://d-maps.com/carte.php?num_car=13436&lang=fr.

Fig. 2

a. Algorithmic approach based on molecular profile, in keeping with the new World Health Organization classification of diffuse low-grade glioma. b. Patient-specific multistage dynamic approach of diffuse low-grade glioma management. This figure is a simplified version of previously proposed strategies.,