Treatment Strategies and Outcomes for Spinal Low-grade Gliomas: A Systematic Review of the Past Quarter Century

This systematic review analyzed treatment strategies and outcomes for spinal low-grade gliomas, based on data from 63 studies encompassing 954 patients. Surgery was the primary treatment, with gross total or subtotal resection associated with improved survival. Subtotal resection followed by radiotherapy prolonged progression-free survival. Fractionated radiotherapy (45-50 Gy) showed disease stabilization and neurologic improvement, with some studies reporting a 5 year progression-free survival of 93% and an overall survival of 100%. Chemotherapy was mainly used in recurrent cases. Prognosis varied by histology; pilocytic astrocytomas showed excellent survival, while infiltrative gliomas were linked to poorer long-term outcomes.