title: Supratentorial low-grade diffuse astrocytoma: medical management.
abstract: Diffuse astrocytomas (DAs) represent less than 10% of all gliomas. They are diffusely infiltrating World Health Organization (WHO) grade II neoplasms that have a median survival in the range of 5-7 years, generally with a terminal phase in which they undergo malignant transformation to glioblastoma (GBM). The goals of treatment in addition to prolonging survival are therefore to prevent progression and malignant transformation, as well as optimally managing symptoms, primarily tumor-associated epilepsy. Available data suggest that the course of this disease is only minimally impacted by adjuvant therapies and that there does not seem to be much difference in terms of outcome of whether patients are treated in the adjuvant setting with irradiation or chemotherapy. We review the experience with chemotherapy as a treatment modality and offer some guidelines for its usage and discuss medical management of arising symptoms.
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA.
authors.forename: Abdulrazag
authors.initials: A
authors.lastname: Ajlan
authors.affiliation: Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA. Electronic address: LRecht@stanford.edu.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Recht
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001254:Astrocytoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D060787:Neoplasm Grading; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D011379:Prognosis; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D000077204:Temozolomide
chemical_list: D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D003606:Dacarbazine; D000077204:Temozolomide