Controversies in the Therapy of Low-Grade Gliomas

  • Ivan D. CarabenciovEmail author
  • Jan C. Buckner
Neuro-oncology (GJ Lesser, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neuro-oncology

Opinion statement

In the context of the new WHO classification system, all low-grade gliomas must have an IDH mutation, with or without 1p/19q codeletion. Upon discovery of the tumor, maximal safe surgical resection is the most appropriate first step due to the current inability to differentiate between IDH mutant and IDH wild–type tumors by imaging alone. In the postoperative setting, based on the synthesis and interpretation of the available data, we recommend utilizing conventional radiation therapy and PCV in all high-risk–low-grade gliomas. For patients felt to be in a low risk category, we recommend maintaining a low threshold to initiate treatment. In the setting of tumor recurrence, consideration of all treatment options is reasonable, but treatment with alkylator therapy has the strongest supporting data.


Low-grade glioma Controversy PCV Temozolomide IDH mutation 


Compliance with Ethical Standards

Conflict of Interest

Ivan D. Carabenciov and Jan C. Buckner declare they have no conflict 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.

References and Recommended Reading

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

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Authors and Affiliations

  1. 1.Department of NeurologyMayo Clinic RochesterRochesterUSA
  2. 2.Department of Medical OncologyMayo Clinic RochesterRochesterUSA

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