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November 1989

The Treatment of Low-Grade Glioma

Arch Neurol. 1989;46(11):1239. doi:10.1001/archneur.1989.00520470107036

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Some patients with low-grade gliomas are treated, and others are not. One would expect a body of opinion to sustain the interventionist and the expectant approach. It was easy to identify someone who would argue that the natural course of low-grade gliomas is so benign and the effects of treatment so uncertain, that with the exception of specific types of tumors, such as childhood cystic astrocytoma of the cerebellum, patients should not be treated outside controlled clinical trials. It proved much more difficult to find someone who would argue a more aggressive approach. Eventually the two ultimately proposed partners in the controversy discussed the issues and concluded that they would be willing to coauthor a consensus! A consensus is a consensus only until it is challenged. Let us hope that a challenge will be based on new evidence.

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