Guidelines for the management and treatment of low-grade gliomas

Treatment options for low-grade gliomas are a challenging dilemma in neuro-oncology. Young age at onset, low rate of growth and long-term treatment sequelae, indicate that minimally invasive treatments are required. However, local recurrence and conversion to malignant glioma occur within 4 to 8 yrs after diagnosis, calling for adjuvant treatment strategies, such as RT and chemotherapy with the aim of improving the disease-free interval. As glioma has a low incidence, and few randomised trials are available in literature, there is little consensus on the correct timing and dosage for RT, or on indications for timing and choice of cytotoxic drugs administration. The present paper therefore focuses on current concepts and future perspectives in the treatment options for low-grade gliomas.