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Toward the Definition of New Endpoints

  • Emmanuel Mandonnet
  • Luc BauchetEmail author
  • Luc Taillandier
  • Hugues Duffau
Chapter

Abstract

Despite considerable advances in the different treatment modalities, there is no evidence-based consensus in the therapeutic management of diffuse low-grade glioma (DLGG). The typically long overall survival of patients with DLGG makes the usual methodology in oncology of randomized trials inadequate. Moreover, any evaluation of treatment efficacy on overall survival has to be associated with an analysis of functional status in these young patients, who are often not that much affected in the initial phase of their disease. In a first step, we propose a new method to compare the efficacy of the different strategies (advocated in different centers): plotting the time to malignant progression versus the time with quality of life. In a second step, new criteria of response to a single treatment are defined on morphological MRI. Contrarily to previous work, our approach takes into account not only the tumor size evolution but also the dynamic changes induced by the therapy.

Keywords

Endpoint determination Functional status Low grade glioma Malignant progression Neuro-oncology Neurosurgery Quality of life 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Emmanuel Mandonnet
    • 1
  • Luc Bauchet
    • 2
    • 3
    • 4
    Email author
  • Luc Taillandier
    • 5
  • Hugues Duffau
    • 6
    • 7
  1. 1.Department of NeurosurgeryLariboisière HospitalParisFrance
  2. 2.Department of Neurosurgery, Hôpital Gui de ChauliacCentre Hospitalier UniversitaireMontpellierFrance
  3. 3.INSERM U1051, Institute for Neurosciences of MontpellierMontpellierFrance
  4. 4.French Brain Tumor DataBase, Groupe de Neuro-Oncologie du Languedoc-Roussillon, Registre des Tumeurs de l’HéraultCentre de Lutte Contre le CancerMontpellierFrance
  5. 5.Neurooncology Unit, Department of Neurology, Hopital CentralUniversity HospitalNancyFrance
  6. 6.Department of Neurosurgery, Gui de Chauliac HospitalMontpellier University Medical CenterMontpellier Cedex 5France
  7. 7.National Institute for Health and Medical Research (INSERM), U1051 Laboratory, Team “Brain Plasticity, Stem Cells and Glial Tumors”, Institute for Neurosciences of MontpellierMontpellier University Medical CenterMontpellierFrance

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