In a young patient with recurrent low-grade glioma s/p gross total resection, is there any role for further observation instead of radiation and chemotherapy?
What is the harm of waiting for another recurrence after a second GTR to delay the toxicity of radiation and chemotherapy? The patient is a woman <40 with recurrent grade 2 oligodendroglioma (genetics pending, but assume 1p19q co-del/ IDH-mut).
Answer from: Radiation Oncologist at Academic Institution
The answer to this question depends on how long it took for the LGG to recur after the first GTR and also on several other criteria such as the size of the recurrence (> or <5 cm), location within the brain (e.g., frontal lobe versus parietal lobe), proximity to eloquent parts of the brain whi...
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Answer from: Radiation Oncologist at Academic Institution
As simple as this question seems to be on the surface, it is actually a very difficult clinical scenario to opine with certainty, primarily because of a lack of data. So, let us address this with each option in mind, weighing the pros and cons:
Observation: We do know that in resected patients, rad...
Answer from: Radiation Oncologist at Community Practice
I agree with Dr. @Stea's considerations. My concerns would weigh on how long it took to recur, as well as the location of the lesion.
A longer interval between the initial resection might lean me towards observation, while a quicker recurrence would prompt treatment. Additionally, if the lesion did...