[Radiotherapy for gliomas in adults: What are the stakes of the follow-up?].
Linked to the difference of prognosis, the terms and conditions of the follow-up of low-grade and high-grade gliomas treated by irradiation differ highly. Patients treated for a low-grade glioma have prolonged survival. In this case, monitoring of toxicities linked to the treatment is a major objective. Opportunistic infections and depression are corticosteroids side effects widely underestimated. Radionecrosis search and differentiation with recurrent disease are done by MRI. Perfusion and spectroscopy showing a choline/creatine ratio increase are in favour of disease recurrence. Cognitive status and quality of life must be evaluated during the follow-up. They have to be evaluated by adapted scales. Cognitive rehabilitation improves interestingly the post-treatment cognitive status. Pseudoprogression rates for high-grade gliomas are near 20%. MRI is the benchmark imaging for its diagnosis. Diffusion weight imaging and spectroscopy are actually the most interesting techniques.
Service de radiothérapie, institut Bergonié, 226, cours de l'Argonne, 33076 Bordeaux cedex, France. Electronic address: vincentatallah298@hotmail.com.
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Atallah
Service de neuro-imagerie diagnostique et thérapeutique, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
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Gariel
Service de radiothérapie, institut Bergonié, 226, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Gillon
Service de neuro-imagerie diagnostique et thérapeutique, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
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Crombé
Service de radiothérapie oncologique, groupe hospitalier Pitié-Salpêtrière, AP-HP, université Pierre-et-Marie-Curie Paris VI, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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Mazeron
D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D060787:Neoplasm Grading
Follow-up; Gliomas; Gliomes; Pseudoprogression; Quality of life; Qualité de vie; Radionecrosis; Radionécrose; Surveillance