Radical surgery after chemotherapy: a new therapeutic strategy to envision in grade II glioma

J Neurooncol. 2006 Nov;80(2):171-6. doi: 10.1007/s11060-006-9168-3. Epub 2006 Apr 28.

Abstract

While surgery is proned in low-grade glioma (LGG), the invasion of functional areas frequently prevents a complete resection. We report the first case of a patient operated on for a left frontal LGG, diagnosed because of seizures, with partial resection due to an invasion of the controlateral hemisphere. Chemotherapy enabled a regression of this controlateral extension. Postchemotherapy surgery performed with intraoperative functional mapping then allowed a complete resection, without sequelae. The patient has a normal socio-professional life, with no seizure. No other treatment was given. There was no recurrence, with a follow-up of 2 years since the second surgery (3.5 years since the first symptom). We propose a new therapeutic strategy in unresectable LGG, with preoperative chemotherapy, to make a radical surgery possible in a second step, while preserving the quality of life.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / surgery*
  • Combined Modality Therapy
  • Corpus Callosum / pathology
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Frontal Lobe / pathology
  • Glioma / drug therapy*
  • Glioma / pathology
  • Glioma / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neurosurgical Procedures
  • Postoperative Care
  • Temozolomide

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide