title: [Treatment for volume upgrading of the low-grade supratentorial glioma after the subtotal neurosurgical resection].
abstract: BACKGROUND
  Low-grade gliomas WHO II (LGG) are mostly detected in patients with neurological symptomatology between 20 and 45 years of age very often as secondary epilepsy. We present two cases in which low-grade gliomas attacked neurological zones. Neurosurgical resection was subtotal because of the risk of the damage in neurocognitive functions in both these patients. After the operation, both patients were followed at neurosurgery department in regular intervals using different imaging methods (MRI, MRS and PET). After resections, the MRI detected the enlargement of the volumes of the tumor residua in both patients.
  
  
  METHODS
  Owing to the risk of up-grading to high-grades glial tumors (overexpression of EGFR and VEGF), both patients were indicated for curative treatment by external beam radiotherapy combined with chemotherapy (Temodal®) and adjuvant chemotherapy.
  
  
  RESULTS
  After the end of this treatment, the MRI proved considerable partial regressions in both patients. Moreover, three months later, the MRI did not prove any residual disease.
  
  
  CONCLUSIONS
  Radiotherapy combined with the administration of Temodal should prolong the OS and TTP in patients with a high risk of up-grading of low-grade gliomas of the brain. Both the patients are in a follow-up program, also because of the risk of duplicite brain tumor.
authors.affiliation: Ustav radiacni onkologie, Praha. ferdinand.trebicky@fnb.cz
authors.forename: F
authors.initials: F
authors.lastname: Třebický
authors.forename: J
authors.initials: J
authors.lastname: Kubeš
authors.forename: R
authors.initials: R
authors.lastname: Bartoš
authors.forename: A
authors.initials: A
authors.lastname: Malucelli
authors.forename: M
authors.initials: M
authors.lastname: Sameš
authors.forename: M
authors.initials: M
authors.lastname: Navrátil
authors.forename: V
authors.initials: V
authors.lastname: Vondráček
authors.forename: S
authors.initials: S
authors.lastname: Medková
authors.forename: M
authors.initials: M
authors.lastname: Mašek
authors.forename: J
authors.initials: J
authors.lastname: Zárubová
mesh_terms: D000328:Adult; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*