Radical surgery after chemotherapy: a new therapeutic strategy to envision in grade II glioma.
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.
Duffau
Hugues
H
Department of Neurosurgery, UMR-S678, Inserm/UPMC, Hôpital Salpêtrière, 75651, Paris, Cedex 13, France. hugues.duffau@psl.ap-hop-paris.fr
Taillandier
Luc
L
Capelle
Laurent
L
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D003337:Corpus Callosum / Q000473:pathology; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005625:Frontal Lobe / Q000473:pathology; D005910:Glioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D011182:Postoperative Care; D000077204:Temozolomide
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide