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A Reply

J. Gregory Cairncross, MD; Normand J. Laperriere, MD

Arch Neurol. 1990;47(10):1139-1140.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

We thank Dr Shaw for his reply to our "controversial consensus."¹ He cautions that diffuse (ie, nonpilocytic) low-grade glioma of the cerebral hemispheres is a serious progressive illness, indolent compared with glioblastoma multiforme, but hardly trivial. Backed by data from the Mayo Clinic and elsewhere, he argues that early accurate diagnosis followed by careful limited-field radiotherapy is the best treatment for these tumors. He acknowledges the potential for delayed toxicity due to treatment but states that the side effects of modern radiotherapy are overemphasized. He concludes that radiotherapy is unquestionably of benefit and identifies radiation dose as the critical issue in the modern treatment of low-grade glioma of the cerebral hemispheres.

Shaw et al² have demonstrated in a careful retrospective analysis that postoperative radiotherapy significantly prolongs the survival of patients with supratentorial low-grade nonpilocytic astrocytoma (including oligoastrocytoma). Patients were ascertained by reviewing the Tissue Registry at the Mayo Clinic. . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Clinical Neurological Sciences and Oncology, University of Western Ontario, London, Canada, and London Regional Cancer Centre (Dr Cairncross); and the Department of Radiology, University of Toronto, and Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Canada (Dr Laperriere).

Footnotes
Accepted for publication February 28, 1990.

Reprint requests to London Regional Cancer Centre, 790 Commissioners Rd E, London, Ontario, Canada N6A 4L6 (Dr Cairncross).

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