Chemotherapy for low-grade gliomas: lessons and questions.

For decades, the role of chemotherapy in the management of gliomas has been controversial. In 2005, Stupp et al[1] presented the first convincing data that the addition of chemotherapy (temozolomide) to radiation therapy (RT) increased median survival by 2.5 months compared with RT alone, leading to a new “standard of care” for glioblastoma multiforme. A similar effect of chemotherapy was reported in 2013, when mature data from Radiation Therapy Oncology Group (RTOG) trial 9402 and European Organisation for Research and Treatment of Cancer (EORTC) trial 26951 revealed that the addition of PCV (procarbazine, lomustine [CCNU], and vincristine) to RT significantly increased overall survival in patients with codeleted anaplastic oligodendrogliomas (AOs) or anaplastic oligoastrocytomas (AOAs) compared with RT alone.