Skip to main content
SpringerLink
Log in

Current Management of Adult Diffuse Infiltrative Low Grade Gliomas

  • Neuro-oncology (L E Abrey, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Diffuse infiltrative low grade gliomas (LGG) account for approximately 15 % of all gliomas. The prognosis of LGG differs between high-risk and low-risk patients notwithstanding varying definitions of what constitutes a high-risk patient. Maximal safe resection optimally is the initial treatment. Surgery that achieves a large volume resection improves both progression-free and overall survival. Based on results of three randomized clinical trials (RCT), radiotherapy (RT) may be deferred in patients with low-risk LGG (defined as age <40 years and having undergone a complete resection), although combined chemoradiotherapy has never been prospectively evaluated in the low-risk population. The recent RTOG 9802 RCT established a new standard of care in high-risk patients (defined as age >40 years or incomplete resection) by demonstrating a nearly twofold improvement in overall survival with the addition of PCV (procarbazine, CCNU, vincristine) chemotherapy following RT as compared to RT alone. Chemotherapy alone as a treatment of LGG may result in less toxicity than RT; however, this has only been prospectively studied once (EORTC 22033) in high-risk patients. A challenge remains to define when an aggressive treatment improves survival without impacting quality of life (QoL) or neurocognitive function and when an effective treatment can be delayed in order to preserve QoL without impacting survival. Current WHO histopathological classification is poorly predictive of outcome in patients with LGG. The integration of molecular biomarkers with histology will lead to an improved classification that more accurately reflects underlying tumor biology, prognosis, and hopefully best therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Tandon A, Schiff D. Therapeutic decision making in patients with newly diagnosed low grade glioma. Curr Treat Options Oncol. 2014;15:529–38. An overview on the role of surgery in the treatment of LGG.

    Article  PubMed  Google Scholar 

  2. Rees J. Temozolomide in low-grade gliomas: living longer and better. J Neurol Neurosurg Psychiatry. 2015;86:359–60.

    Article  PubMed  Google Scholar 

  3. Wen PY, DeAngelis LM. Chemotherapy for low-grade gliomas: emerging consensus on its benefits. Neurology. 2007;68:1762–3.

    Article  PubMed  Google Scholar 

  4. Ius T, Isola M, Budai R, Pauletto G, Tomasino B, Fadiga L, et al. Low-grade glioma surgery in eloquent areas: volumetric analysis of extent of resection and its impact on overall survival. A single-institution experience in 190 patients: clinical article. J Neurosurg. 2012;117:1039–52.

    Article  PubMed  Google Scholar 

  5. Duffau H, Taillandier L. New concepts in the management of diffuse low-grade glioma: proposal of a multistage and individualized therapeutic approach. Neuro-Oncology. 2015;17:332–42.

    PubMed  Google Scholar 

  6. Hollon T, Hervey-Jumper SL, Sagher O, Orringer DA. Advances in the surgical management of low-grade glioma. Semin Radiat Oncol. 2015;25:181–8.

    Article  PubMed  Google Scholar 

  7. Soffietti R, Baumert BG, Bello L, von Deimling A, Duffau H, Frénay M, et al. Guidelines on management of low-grade gliomas: report of an EFNS-EANO Task Force. Eur J Neurol Off J Eur Fed Neurol Soc. 2010;17:1124–33. An excellent review of treatment of LGG.

    CAS  Google Scholar 

  8. Chang EF, Potts MB, Keles GE, Lamborn KR, Chang SM, Barbaro NM, et al. Seizure characteristics and control following resection in 332 patients with low-grade gliomas. J Neurosurg. 2008;108:227–35.

    Article  PubMed  Google Scholar 

  9. Pallud J, Audureau E, Blonski M, Sanai N, Bauchet L, Fontaine D, et al. Epileptic seizures in diffuse low-grade gliomas in adults. Brain J Neurol. 2014;137:449–62.

    Article  Google Scholar 

  10. Gorlia T, Wu W, Wang M, Baumert BG, Mehta M, Buckner JC, et al. New validated prognostic models and prognostic calculators in patients with low-grade gliomas diagnosed by central pathology review: a pooled analysis of EORTC/RTOG/NCCTG phase III clinical trials. Neuro-Oncology. 2013;15:1568–79.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Smith JS, Chang EF, Lamborn KR, Chang SM, Prados MD, Cha S, et al. Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26:1338–45.

    Article  Google Scholar 

  12. Jakola AS, Unsgård G, Myrmel KS, Kloster R, Torp SH, Losvik OK, et al. Surgical strategy in grade II astrocytoma: a population-based analysis of survival and morbidity with a strategy of early resection as compared to watchful waiting. Acta Neurochir (Wien). 2013;155:2227–35.

    Article  Google Scholar 

  13. Kiebert GM, Curran D, Aaronson NK, Bolla M, Menten J, Rutten EH, et al. Quality of life after radiation therapy of cerebral low-grade gliomas of the adult: results of a randomised phase III trial on dose response (EORTC trial 22844). EORTC Radiotherapy Co-operative Group. Eur J Cancer Oxf Engl 1990. 1998;34:1902–9.

    CAS  Google Scholar 

  14. Shaw E, Arusell R, Scheithauer B, O’Fallon J, O’Neill B, Dinapoli R, et al. Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol Off J Am Soc Clin Oncol. 2002;20:2267–76.

    Article  CAS  Google Scholar 

  15. Brown PD, Buckner JC, O’Fallon JR, Iturria NL, Brown CA, O’Neill BP, et al. Effects of radiotherapy on cognitive function in patients with low-grade glioma measured by the Folstein mini-mental state examination. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21:2519–24.

    Article  Google Scholar 

  16. van den Bent MJ, Afra D, de Witte O, Ben Hassel M, Schraub S, Hoang-Xuan K, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet Lond Engl. 2005;366:985–90.

    Article  Google Scholar 

  17. Shaw EG, Berkey B, Coons SW, Bullard D, Brachman D, Buckner JC, et al. Recurrence following neurosurgeon-determined gross-total resection of adult supratentorial low-grade glioma: results of a prospective clinical trial. J Neurosurg. 2008;109:835–41.

    Article  PubMed  Google Scholar 

  18. van den Bent MJ, Snijders TJ, Bromberg JEC. Current treatment of low grade gliomas. Memo. 2012;5:223–7.

    Article  PubMed Central  PubMed  Google Scholar 

  19. van den Bent MJ. Practice changing mature results of RTOG study 9802: another positive PCV trial makes adjuvant chemotherapy part of standard of care in low-grade glioma. Neuro-Oncology. 2014;16:1570–4.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Douw L, Klein M, Fagel SS, van den Heuvel J, Taphoorn MJ, Aaronson NK, et al. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol. 2009;8:810–8.

    Article  PubMed  Google Scholar 

  21. Mason WP, Krol GS, DeAngelis LM. Low-grade oligodendroglioma responds to chemotherapy. Neurology. 1996;46:203–7.

    Article  CAS  PubMed  Google Scholar 

  22. Soffietti R, Rudà R, Bradac GB, Schiffer D. PCV chemotherapy for recurrent oligodendrogliomas and oligoastrocytomas. Neurosurgery. 1998;43:1066–73.

    Article  CAS  PubMed  Google Scholar 

  23. Buckner JC, Gesme D, O’Fallon JR, Hammack JE, Stafford S, Brown PD, et al. Phase II trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma: efficacy and associations with chromosomal abnormalities. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21:251–5.

    Article  CAS  Google Scholar 

  24. Stege EMB, Kros JM, de Bruin HG, Enting RH, van Heuvel I, Looijenga LHJ, et al. Successful treatment of low-grade oligodendroglial tumors with a chemotherapy regimen of procarbazine, lomustine, and vincristine. Cancer. 2005;103:802–9.

    Article  PubMed  Google Scholar 

  25. Lebrun C, Fontaine D, Bourg V, Ramaioli A, Chanalet S, Vandenbos F, et al. Treatment of newly diagnosed symptomatic pure low-grade oligodendrogliomas with PCV chemotherapy. Eur J Neurol Off J Eur Fed Neurol Soc. 2007;14:391–8.

    CAS  Google Scholar 

  26. Peyre M, Cartalat-Carel S, Meyronet D, Ricard D, Jouvet A, Pallud J, et al. Prolonged response without prolonged chemotherapy: a lesson from PCV chemotherapy in low-grade gliomas. Neuro-Oncology. 2010;12:1078–82.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Taal W, van der Rijt CCD, Dinjens WNM, Sillevis Smitt PAE, Wertenbroek AAACM, Bromberg JEC, et al. Treatment of large low-grade oligodendroglial tumors with upfront procarbazine, lomustine, and vincristine chemotherapy with long follow-up: a retrospective cohort study with growth kinetics. J Neurooncol. 2015;121:365–72.

    Article  CAS  PubMed  Google Scholar 

  28. Brada M, Hoang-Xuan K, Rampling R, Dietrich PY, Dirix LY, Macdonald D, et al. Multicenter phase II trial of temozolomide in patients with glioblastoma multiforme at first relapse. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2001;12:259–66.

    Article  CAS  Google Scholar 

  29. Hoang-Xuan K, Capelle L, Kujas M, Taillibert S, Duffau H, Lejeune J, et al. Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1p deletions. J Clin Oncol Off J Am Soc Clin Oncol. 2004;22:3133–8.

    Article  CAS  Google Scholar 

  30. Kaloshi G, Benouaich-Amiel A, Diakite F, Taillibert S, Lejeune J, Laigle-Donadey F, et al. Temozolomide for low-grade gliomas: predictive impact of 1p/19q loss on response and outcome. Neurology. 2007;68:1831–6.

    Article  CAS  PubMed  Google Scholar 

  31. Kaloshi G, Rroji A, Petrela M. Upfront chemotherapy with CCNU alone for adults’ low-grade gliomas: a clinical analysis. J Neurooncol. 2014;117:373–4.

    Article  PubMed  Google Scholar 

  32. Temozolomide chemotherapy versus radiotherapy in molecularly characterized (1p loss) low-grade glioma: a randomized phase III intergroup study by the EORTC/NCIC-CTG/TROG/MRC-CTU (EORTC 22033–26033). J. Clin. Oncol. [Internet]. [cited 2015 Aug 8]; Available from: http://meetinglibrary.asco.org/content/111001-132.

  33. Radiotherapy in relation to temozolomide: Subgroup analysis of molecular markers of the randomized phase III study by the EORTC/NCIC-CTG/TROG/MRC-CTU (EORTC 22033–26033) in patients with a high risk low-grade glioma. J. Clin. Oncol. [Internet]. [cited 2015 Sep 27]; Available from: http://meetinglibrary.asco.org/content/147310-156.

  34. Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, et al. Initial treatment patterns over time for anaplastic oligodendroglial tumors. Neuro-Oncology. 2012;14:761–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Schaff LR, Lassman AB. Indications for treatment: is observation or chemotherapy alone a reasonable approach in the management of low-grade gliomas? Semin Radiat Oncol. 2015;25:203–9.

    Article  PubMed  Google Scholar 

  36. van den Bent MJ. Chemotherapy for low-grade glioma: when, for whom, which regimen? Curr. Opin. Neurol. 2015.

  37. van den Bent MJ, Taphoorn MJB, Brandes AA, Menten J, Stupp R, Frenay M, et al. Phase II study of first-line chemotherapy with temozolomide in recurrent oligodendroglial tumors: the European Organization for Research and Treatment of Cancer Brain Tumor Group Study 26971. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21:2525–8.

    Article  Google Scholar 

  38. Pace A, Vidiri A, Galiè E, Carosi M, Telera S, Cianciulli AM, et al. Temozolomide chemotherapy for progressive low-grade glioma: clinical benefits and radiological response. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2003;14:1722–6.

    Article  CAS  Google Scholar 

  39. Quinn JA, Reardon DA, Friedman AH, Rich JN, Sampson JH, Provenzale JM, et al. Phase II trial of temozolomide in patients with progressive low-grade glioma. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21:646–51.

    Article  CAS  Google Scholar 

  40. Weller M, van den Bent M, Hopkins K, Tonn JC, Stupp R, Falini A, et al. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol. 2014;15:e395–403.

    Article  PubMed  Google Scholar 

  41. Wick W, Wiestler B, Platten M. Treatment of anaplastic glioma. Cancer Treat Res. 2015;163:89–101.

    Article  PubMed  Google Scholar 

  42. Ahluwalia MS, Chang SM. Medical therapy of gliomas. J Neurooncol. 2014;119:503–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Laack NN, Sarkaria JN, Buckner JC. Radiation Therapy Oncology Group 9802: controversy or consensus in the treatment of newly diagnosed low-grade glioma? Semin Radiat Oncol. 2015;25:197–202.

    Article  PubMed  Google Scholar 

  44. Fisher BJ, Hu C, Macdonald DR, Lesser GJ, Coons SW, Brachman DG, et al. Phase 2 study of temozolomide-based chemoradiation therapy for high-risk low-grade gliomas: preliminary results of Radiation Therapy Oncology Group 0424. Int J Radiat Oncol Biol Phys. 2015;91:497–504.

    Article  CAS  PubMed  Google Scholar 

  45. Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG. J. Clin. Oncol. [Internet]. [cited 2015 Sep 27]; Available from: http://meetinglibrary.asco.org/content/127483-144. This phase III trial established a new standard of care in high-risk LLG patients.

  46. Shaw EG, Wang M, Coons SW, Brachman DG, Buckner JC, Stelzer KJ, et al. Randomized trial of radiation therapy plus procarbazine, lomustine, and vincristine chemotherapy for supratentorial adult low-grade glioma: initial results of RTOG 9802. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30:3065–70.

    Article  CAS  Google Scholar 

  47. Intergroup Radiation Therapy Oncology Group Trial 9402, Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B, et al. Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24:2707–14.

    Article  Google Scholar 

  48. van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJB, Bernsen HJJA, et al. Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24:2715–22.

    Article  Google Scholar 

  49. Nabors LB, Portnow J, Ammirati M, Brem H, Brown P, Butowski N, et al. Central nervous system cancers, version 2.2014. Featured updates to the NCCN Guidelines. J Natl Compr Cancer Netw JNCCN. 2014;12:1517–23.

    PubMed  Google Scholar 

  50. Chamberlain MC. Does RTOG 9802 change practice with respect to newly diagnosed low-grade glioma? J Clin Oncol Off J Am Soc Clin Oncol. 2013;31:652–3.

    Article  CAS  Google Scholar 

  51. Pignatti F, van den Bent M, Curran D, Debruyne C, Sylvester R, Therasse P, et al. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol Off J Am Soc Clin Oncol. 2002;20:2076–84.

    Article  Google Scholar 

  52. Daniels TB, Brown PD, Felten SJ, Wu W, Buckner JC, Arusell RM, et al. Validation of EORTC prognostic factors for adults with low-grade glioma: a report using intergroup 86-72-51. Int J Radiat Oncol Biol Phys. 2011;81:218–24.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Gozé C, Blonski M, Le Maistre G, Bauchet L, Dezamis E, Page P, et al. Imaging growth and isocitrate dehydrogenase 1 mutation are independent predictors for diffuse low-grade gliomas. Neuro-Oncology. 2014;16:1100–9.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Guillevin R, Menuel C, Duffau H, Kujas M, Capelle L, Aubert A, et al. Proton magnetic resonance spectroscopy predicts proliferative activity in diffuse low-grade gliomas. J Neurooncol. 2008;87:181–7.

    Article  CAS  PubMed  Google Scholar 

  55. van den Bent MJ, Jaeckle K, Baumert B, Wick W. RTOG 9802: good wines need aging. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31:653–4.

    Article  Google Scholar 

  56. van den Bent MJ. Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective. Acta Neuropathol (Berl). 2010;120:297–304.

    Article  Google Scholar 

  57. Aldape K, Burger PC, Perry A. Clinicopathologic aspects of 1p/19q loss and the diagnosis of oligodendroglioma. Arch Pathol Lab Med. 2007;131:242–51.

    CAS  PubMed  Google Scholar 

  58. Coons SW, Johnson PC, Scheithauer BW, Yates AJ, Pearl DK. Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer. 1997;79:1381–93.

    Article  CAS  PubMed  Google Scholar 

  59. Olar A, Sulman EP. Molecular markers in low-grade glioma-toward tumor reclassification. Semin Radiat Oncol. 2015;25:155–63.

    Article  PubMed  Google Scholar 

  60. Cancer Genome Atlas Research Network, Brat DJ, Verhaak RGW, Aldape KD, Yung WKA, Salama SR, et al. Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med. 2015;372:2481–98. Proposal for a new classification of grade II and III gliomas.

    Article  Google Scholar 

  61. Bruner JM, Inouye L, Fuller GN, Langford LA. Diagnostic discrepancies and their clinical impact in a neuropathology referral practice. Cancer. 1997;79:796–803.

    Article  CAS  PubMed  Google Scholar 

  62. Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF, et al. Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas. Oncotarget. 2012;3:709–22.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Yan H, Parsons DW, Jin G, McLendon R, Rasheed BA, Yuan W, et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med. 2009;360:765–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  64. Louis DN, Perry A, Burger P, Ellison DW, Reifenberger G, von Deimling A, et al. International Society Of Neuropathology—Haarlem consensus guidelines for nervous system tumor classification and grading. Brain Pathol Zurich Switz. 2014;24:429–35.

    Article  Google Scholar 

  65. Eckel-Passow JE, Lachance DH, Molinaro AM, Walsh KM, Decker PA, Sicotte H, et al. Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med. 2015;372:2499–508. Proposal for a new classification of grade II and III gliomas.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  66. Suzuki H, Aoki K, Chiba K, Sato Y, Shiozawa Y, Shiraishi Y, et al. Mutational landscape and clonal architecture in grade II and III gliomas. Nat Genet. 2015;47:458–68. Proposal for a new classification of grade II and III gliomas.

    Article  CAS  PubMed  Google Scholar 

  67. Reuss DE, Sahm F, Schrimpf D, Wiestler B, Capper D, Koelsche C, et al. ATRX and IDH1-R132H immunohistochemistry with subsequent copy number analysis and IDH sequencing as a basis for an “integrated” diagnostic approach for adult astrocytoma, oligodendroglioma and glioblastoma. Acta Neuropathol (Berl). 2015;129:133–46. Proposal for a new classification of grade II and III gliomas.

    Article  CAS  Google Scholar 

  68. Weller M, Weber RG, Willscher E, Riehmer V, Hentschel B, Kreuz M, et al. Molecular classification of diffuse cerebral WHO grade II/III gliomas using genome- and transcriptome-wide profiling improves stratification of prognostically distinct patient groups. Acta Neuropathol (Berl). 2015;129:679–93. Proposal for a new classification of grade II and III gliomas.

    Article  CAS  Google Scholar 

  69. Dubbink HJ, Taal W, van Marion R, Kros JM, van Heuvel I, Bromberg JE, et al. IDH1 mutations in low-grade astrocytomas predict survival but not response to temozolomide. Neurology. 2009;73:1792–5.

    Article  CAS  PubMed  Google Scholar 

  70. Taylor JW, Chi AS, Cahill DP. Tailored therapy in diffuse gliomas: using molecular classifiers to optimize clinical management. Oncol Williston Park N. 2013;27:504–14.

    Google Scholar 

  71. Blaes J, Weiler M, Sahm F, Hentschel B, Osswald M, Czabanka M, et al. NDRG1 prognosticates the natural course of disease in WHO grade II glioma. J Neurooncol. 2014;117:25–32.

    Article  CAS  PubMed  Google Scholar 

  72. Prabhu RS, Won M, Shaw EG, Hu C, Brachman DG, Buckner JC, et al. Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: secondary analysis of RTOG 98–02. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32:535–41.

    Article  Google Scholar 

  73. Klein M, Duffau H, De Witt Hamer PC. Cognition and resective surgery for diffuse infiltrative glioma: an overview. J Neurooncol. 2012;108:309–18.

    Article  PubMed Central  PubMed  Google Scholar 

  74. Duffau H. Cognitive assessment in glioma patients. J Neurosurg. 2013;119:1348–9.

    Article  PubMed  Google Scholar 

  75. Surma-aho O, Niemelä M, Vilkki J, Kouri M, Brander A, Salonen O, et al. Adverse long-term effects of brain radiotherapy in adult low-grade glioma patients. Neurology. 2001;56:1285–90.

    Article  CAS  PubMed  Google Scholar 

  76. Jim HSL, Phillips KM, Chait S, Faul LA, Popa MA, Lee Y-H, et al. Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30:3578–87.

    Article  CAS  Google Scholar 

  77. Pereira Dias G, Hollywood R, Bevilaqua MC do N, da Luz ACD da S, Hindges R, Nardi AE, et al. Consequences of cancer treatments on adult hippocampal neurogenesis: implications for cognitive function and depressive symptoms. Neuro-Oncology. 2014;16:476–92.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Schumacher T, Bunse L, Pusch S, Sahm F, Wiestler B, Quandt J, et al. A vaccine targeting mutant IDH1 induces antitumour immunity. Nature. 2014;512:324–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neuro-oncology, Department of Neurosurgery, Lille University Hospital, Lille, France

    Emilie Le Rhun

  2. Breast unit, Department of Medical Oncology, Oscar Lambret Center, Lille, France

    Emilie Le Rhun

  3. PRISM Inserm U1191, Villeneuve d’Ascq, France

    Emilie Le Rhun

  4. Department of Neurology, Pitié-Salpétrière Hospital, UPMC-Paris VI University, Paris, France

    Sophie Taillibert

  5. Department of Radiation Oncology, Pitié-Salpétrière Hospital, UPMC-Paris VI University, Paris, France

    Sophie Taillibert

  6. Division of Neuro-Oncology, Department of Neurology and Neurological Surgery, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Ave E, MS G4940, PO Box 19023, Seattle, WA, 98109, USA

    Marc C. Chamberlain

Authors
  1. Emilie Le Rhun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sophie Taillibert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marc C. Chamberlain
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc C. Chamberlain.

Ethics declarations

Conflict of Interest

Emilie Le Rhun, Sophie Taillibert, and Marc C. Chamberlain each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Neuro-oncology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Le Rhun, E., Taillibert, S. & Chamberlain, M.C. Current Management of Adult Diffuse Infiltrative Low Grade Gliomas. Curr Neurol Neurosci Rep 16, 15 (2016). https://doi.org/10.1007/s11910-015-0615-4

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11910-015-0615-4

Keywords

Search

Navigation