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Can chemotherapy replace radiotherapy in low-grade gliomas? Time for randomized
studies
van den Bent MJ
Department of Neurology/Neuro-Oncology Unit, Daniel den Hoed
Cancer Center, PO Box 5201, 3008AE, Rotterdam, The Netherlands.
For the last three decades surgery and radiotherapy have been the mainstay of
treatment for patients with low-grade gliomas, despite a lack of support from
randomized controlled trials.
Recent developments in our knowledge of low-grade tumor chemosensitivity and the
approval of temozolomide for treatment of gliomas have led to increased interest
in chemotherapy for treating low-grade gliomas.
Despite challenges, including response assessment and appropriate patient
selection, several phase II studies investigating chemotherapeutic treatment of
low-grade gliomas have yielded promising results.
Although most of these phase II studies are of limited sample size, they have
shown that chemotherapy might induce clinically relevant responses and disease
stabilization in patients with low-grade gliomas.
As expected, low-grade oligodendroglioma is sensitive to chemotherapy, but
responses were also seen in astrocytic tumors.
Randomized, controlled studies should be conducted to determine the clinical
significance of responses observed in phase II studies and to assess time to
progression.
Two randomized, controlled studies are currently investigating chemotherapy in
the treatment of low-grade gliomas.
Although it will take years before the data are available, these studies will
help define the role of chemotherapy in the treatment of low-grade
gliomas.
Perhaps then we can answer the question, can chemotherapy replace radiotherapy
in low-grade gliomas?
PMID: 14765384 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14765384
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