The question of how best to treat low-grade gliomas, be it aggressively or not at all, is controversial. However, symptomatic low-grade gliomas require prompt treatment because of the neurological impairment, the danger of uncontrolled seizures and consequent deterioration of quality of life.

This paper reports the long-term follow-up for 71 months of 7 patients treated with procarbazine, lomustine and vincristine (PCV) for symptomatic low-grade oligodendromas. The mean age at diagnosis was 47 years; the mean time from first symptoms to initiation of PCV therapy was 62 months (range 15 to 147).

Initially all patients responded favorably with improvement of neurological and radiological features. Chemotherapy was clinically well tolerated, the main side effect being low-level haematological toxicity. During follow-up no progression was noted in 2 patients. In the 5 others progression after commencing treatment was noted at 56 +/- 12 months (range 38 to 73). Four of them responded well to second line treatment.

The paper concludes that PCV combined therapy is a therapeutic option that should be considered for progressive symptomatic low-grade gliomas even when tumour bulk is large. The treatment is of modest toxicity, improves quality of life and is capable of long-term tumour stabilization.

34 references.