Abstract
BackgroundThe treatment recommendations for Low-grade Gliomas (LGG) underwent profound changes due to results from RTOG 9802 published in April 2016. This work aims to investigate whether the results from the trial were already incorporated into the treatment recommendations at German oncology centers before an update of the official guidelines.MethodsAn online based questionnaire with questions covering all aspects of adjuvant treatments of LGGs was generated, including three cases with distinct clinical situations. We contacted all members of the neuro-oncologic working group (NOA) of the German Cancer Society (DKG) as well as all German-speaking members of the European Low-Grade Glioma Network via E-mail.ResultsWe collected 38 responses. All responders were at least specialists; they predominantly worked at tertiary hospitals with a high volume of LGGs treated annually (75% with more than 10 cases per year). All responders stated to consent treatment recommendation for LGGs within interdisciplinary oncologic boards. The treatment recommendations for LGGs changed profoundly between 2015 and 12/2016. There is a trend towards PCV-based multimodal treatments, especially for oligodendroglial LGGs, as well as a trend away from watchful-waiting-policies for astrocytic LGGs.ConclusionNeurooncologists do adapt results from clinical trials quickly. None the less, there is still an immense heterogeneity within the treatment recommendations, predominantly for astrocytic LGGs. Well planned clinical trials and concise treatment recommendations are warranted; additionally, individual counseling of patients is essential.
Highlights
The treatment recommendations for Low-grade Gliomas (LGG) underwent profound changes due to results from RTOG 9802 published in April 2016
Responses and structural background We counted 150 visits resulting in 38 completed surveys. 35/38 responders worked at tertiary care hospitals, and the remaining three responders worked at major regional hospitals (Fig. 1, left panel)
Most responders worked in high-volume centers with > 10 LGG cases per year
Summary
The treatment recommendations for Low-grade Gliomas (LGG) underwent profound changes due to results from RTOG 9802 published in April 2016. This work aims to investigate whether the results from the trial were already incorporated into the treatment recommendations at German oncology centers before an update of the official guidelines. Low-grade Gliomas (LGG) are a rarely occurring malignancy that makes up 5–10% of all primary brain malignancies. Depending on the molecular pattern, on risk factors and treatment regimens, the median survival times range between 3.2 years and > 15 years [1, 2]. This regimen results in an increase of the median overall survival (mOS) from 7.8 years to 13.3 years and of the median progression-free survival (mPFS) from 4.0 to 10.4 years. The official EANO guideline was updated only recently [6]
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