Low-grade gliomas: A single-institute experience

Abstract

Introduction: Low-grade gliomas (LGG) are relatively rare tumors. They comprise 5% of all brain tumors and 15% of all gliomas. As per WHO classification diffuse infiltrating LGG s fall under Grade II tumors. Although these tumors are slow growing but eventually they progress to high-grade gliomas, so these patients should be treated aggressively. Materials and Methods: From January 2012 to January 2017, clinical information of patients, who had LGG, was collected retrospectively from patient registries at the radiation oncology department of our institute. Results: A total of 25 patients were analyzed. Out of the entire cohort, 64% were males, and 36% were females. The most common presenting symptom in our patients was seizures and blurring of vision (44% each). Cerebrum was the mos common site of lesion in 19 out of 25 (76.0%) cases, and among those 19 cases, frontal lobe was involved in 12 cases (63.1%). Craniotomy with tumor decompression was performed in all patients. Gross total excision was possible in only 2 (8%) out of 25 patients, whereas the remaining 23 (92%) patients underwent subtotal or near total excision only. These 23 patients received concurrent chemoradiation by cobalt-60 unit to a dose of 60 Gy with weekly temozolomide. 18 out of 23 (78.2%) patients received adjuvant six cycles temozolomidein view of residual disease after concurrent chemoradiotherapy. At the last follow-up, all the 25 patients were alive, 20 patients had no disease on contrast-enhanced magnetic resonance imaging, while five patients had stable disease. Conclusion: We conclude that LGG is a disease of young adults with seizures as most common presenting symptom. If treated with multidisciplinary treatment these patients have the long disease and disability-free survival. Neurocognitive dysfunction is low in our study group, but it needs longer follow-up.