Chemotherapy for low-grade gliomas

The management of low-grade oligodendrogliomas and oligoastrocytomas has been further complicated by recent reports documenting the chemosensitivity of these tumours. Preliminary results suggest that low-grade oligodendroglial tumours are less dramatic and predictable in their response to chemotherapy than their anaplastic counterparts. Nonetheless, the use of chemotherapy as initial treatment for these indolent neoplasms has inherent appeal, particularly if this strategy permits the delay or elimination of cranial irradiation. Before the use of chemotherapy becomes standard initial therapy for these neoplasms, further efforts will be required to describe in greater detail the susceptibility of these tumours to chemotherapy, document the delayed toxicities of chemotherapy for low-grade oligodendrogliomas, identify the most therapeutic agents or regimens, and correlate clinical and radiographic response with molecular markers of chemosensitivity.